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Chatzivasileiou P, Armeni E, Chedraui P, Kontou L, Augoulea A, Palaiologou A, Kaparos G, Panoulis K, Alexandrou A, Vlachos N, Lambrinoudaki I. Postmenopausal women with higher TSH values within the normal range present improved handgrip strength: a pilot study. Gynecol Endocrinol 2024; 40:2333432. [PMID: 38567465 DOI: 10.1080/09513590.2024.2333432] [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: 11/06/2023] [Accepted: 03/14/2024] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE To evaluate the possible association between thyroid function within the euthyroid range and musculoskeletal parameters as well as body composition in a sample of postmenopausal women. METHODS This cross-sectional study included 96 postmenopausal women with serum thyroid-stimulating hormone (TSH) within the normal laboratory reference range. Fasting venous blood samples were obtained for biochemical/hormonal assessment. Bone status and body composition were measured using Dual Energy X-ray absorptiometry (DXA). Physical activity was quantified using the International Physical Activity Questionnaire (IPAQ) index. RESULTS Serum TSH correlated with handgrip strength (HGS, r-coefficient = 0.233, p = .025), and total body bone mineral density (BMD) T-score values (r-coefficient = 0.321, p = .003). HGS measures were associated with BMD (r-coefficient = 0.415, p < .001), with bone mineral content (BMC, r-coefficient = 0.427, p < .001), and lean mass (r-coefficient = 0.326, p = .003). Women with low muscle strength, defined as HGS < 16 kg, had lower TSH levels than women with normal muscle strength (low vs. normal muscle strength, ANCOVA 1.13 ± 0.49 mU/L vs. 1.60 ± 0.83 mU/L, p = 0.024) independently of age, BMD, percentage of body fat or absolute lean mass. Multivariable linear regression analysis showed that HGS values were associated with TSH measurements (β-coefficient = 0.246, p = .014) and BMD T-score values (β-coefficient = 0.306, p = .002). All models were adjusted for age, body mass index (BMI), vitamin D, low-density lipoprotein cholesterol, current smoking, physical activity, and homeostasis model assessment of insulin resistance. CONCLUSIONS In this sample of postmenopausal women, lower serum TSH values, within normal range, were associated with lower muscle strength compared to higher normal TSH values. Further research is needed to elucidate the significance of our preliminary findings.
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Affiliation(s)
- Panagiota Chatzivasileiou
- Second Department of Obstetrics and Gynecology, Menopause Clinic, Aretaieio Hospital, University of Athens, Athens, Greece
| | - Eleni Armeni
- Second Department of Obstetrics and Gynecology, Menopause Clinic, Aretaieio Hospital, University of Athens, Athens, Greece
- Royal Free Hospital, NHS Foundation Trust, University College London Medical School, London, UK
| | - Peter Chedraui
- Escuela de Posgrado en Salud, Universidad Espíritu Santo, Samborondón, Ecuador
| | - Loraina Kontou
- Second Department of Obstetrics and Gynecology, Menopause Clinic, Aretaieio Hospital, University of Athens, Athens, Greece
| | - Areti Augoulea
- Second Department of Obstetrics and Gynecology, Menopause Clinic, Aretaieio Hospital, University of Athens, Athens, Greece
| | - Anastasia Palaiologou
- Second Department of Obstetrics and Gynecology, Menopause Clinic, Aretaieio Hospital, University of Athens, Athens, Greece
| | - George Kaparos
- Biochemical Laboratory, Aretaieio Hospital, University of Athens, Athens, Greece
| | - Konstantinos Panoulis
- Second Department of Obstetrics and Gynecology, Menopause Clinic, Aretaieio Hospital, University of Athens, Athens, Greece
| | - Andreas Alexandrou
- Second Department of Obstetrics and Gynecology, Menopause Clinic, Aretaieio Hospital, University of Athens, Athens, Greece
| | - Nikolaos Vlachos
- Second Department of Obstetrics and Gynecology, Menopause Clinic, Aretaieio Hospital, University of Athens, Athens, Greece
| | - Irene Lambrinoudaki
- Second Department of Obstetrics and Gynecology, Menopause Clinic, Aretaieio Hospital, University of Athens, Athens, Greece
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Villanueva-Saz S, Aranda MDC, Jiménez MDLÁ, de Andrés PJ, Verde M, Climent M, Lebrero Berna ME, Marteles Aragüés D, Fernández A. Serum protein electrophoresis in European mink ( Mustela lutreola): reference intervals and comparison of agarose gel electrophoresis and capillary zone electrophoresis. Vet Q 2024; 44:1-11. [PMID: 38389258 PMCID: PMC10896155 DOI: 10.1080/01652176.2024.2318195] [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: 08/07/2023] [Accepted: 12/29/2023] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Knowledge of reference intervals for blood analytes, including serum protein fractions, is of great importance for the identification of infectious and inflammatory diseases and is often lacking in wild animal species. MATERIAL AND METHODS Serum samples were obtained from European minks enrolled in the breeding program (n = 55). Agarose gel electrophoresis (AGE) and capillary zone electrophoresis (CZE) were used to separate and identify protein fractions. Albumin, α1, α2, β, and γ-globulins fractions were identified in all mink sera by both electrophoresis methods. Reference intervals (90% CI) were determined following the 2008 guidelines of the Clinical Laboratory Standard Institute. The methods were compared using Passing-Bablok regression, Bland-Altman analysis, and Lin's concordance correlation. RESULTS A significant bias was found between methods for α1, α2, and γ-globulin. Lin's concordance correlation was considered unacceptable for α1, α2, and β-globulins. Differences for gender between methods were found for albumin and α2-globuins, which were higher for males than females. γ-globulins were higher for adults than young minks using both methods; however, α1 and α2-globulins were lower. CONCLUSION Both methods are adequate for identifying serum protein disorders, but the AGE and CZE methods are not equivalent. Therefore, reference intervals for each technique are required.
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Affiliation(s)
- Sergio Villanueva-Saz
- Animal Pathology Department, Veterinary Faculty, Zaragoza University, Zaragoza, Spain
- Clinical Immunology Laboratory, Veterinary Faculty, Zaragoza University, Zaragoza, Spain
- Aragon Agroalimentary Institute-IA2, Zaragoza University-CITA, Zaragoza, Spain
| | - María del Carmen Aranda
- FIEB Foundation (Fundación para la Investigación en etología y biodiversidad), Toledo, Spain
| | | | - Paloma Jimena de Andrés
- Department of Animal Medicine and Surgery, Veterinary Faculty, Complutense University of Madrid, Madrid, Spain
| | - Maite Verde
- Animal Pathology Department, Veterinary Faculty, Zaragoza University, Zaragoza, Spain
- Clinical Immunology Laboratory, Veterinary Faculty, Zaragoza University, Zaragoza, Spain
- Aragon Agroalimentary Institute-IA2, Zaragoza University-CITA, Zaragoza, Spain
| | - María Climent
- Department of Anatomy, Embryology and Animal Genetic, Veterinary Faculty, Zaragoza University, Zaragoza, Spain
| | | | | | - Antonio Fernández
- Animal Pathology Department, Veterinary Faculty, Zaragoza University, Zaragoza, Spain
- Clinical Immunology Laboratory, Veterinary Faculty, Zaragoza University, Zaragoza, Spain
- Aragon Agroalimentary Institute-IA2, Zaragoza University-CITA, Zaragoza, Spain
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Haouzi P, Raghavan S, McCully J. Using the gli spirographic prediction equations to revisit the allometric relationships between lung volumes, height and age in adults. Respir Physiol Neurobiol 2024; 324:104243. [PMID: 38432596 DOI: 10.1016/j.resp.2024.104243] [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: 01/04/2024] [Revised: 02/19/2024] [Accepted: 02/27/2024] [Indexed: 03/05/2024]
Abstract
The determination the forced vital capacity (FVC) and the forced expiratory volume in 1 second (FEV1) during spirometry studies, is at the core of the evaluation of the pulmonary function of patients with respiratory diseases. The Global Lung Function Initiative (GLI) offers the most extensive data set of normal lung functions available, which is currently used to determine the average expected/predicted FEV1 and FVC (predV), and their lower limit of normal (LLN, 5th percentile) at any given height and age for women and men. These prediction equations are currently expressed in a rather complex form: predV = exp [p+ (a x Ln (height) + (n x Ln (age)) + spline] and LLN = exp(Ln (predV) + Ln (1 - 1.645 x S x CV)/S); and are currently used to generate interpretations in commercialized spinographic system. However, as shown in this paper, these equations contain physiological and fundamental allometric information on lung volumes that become obvious when rewriting mean predicted values as a "simple" power function of height and LLN as a percentage of the mean predicted values. We therefore propose to present the equations of prediction obtained from the GLI data using simplified expressions in adults (18-95 years old) to reveal some of their physiological and allometric meaning. Indeed, when predicted FEV1 and FVC (predV) were expressed under the form predV= αx heightax b(age), the resulting exponent (a) ranges between 2 and 3, transforming the one dimension of a length (size) into a volume, akin to the third-order power (cubic) function of height historically used to predict lung volumes. Only one function, b (age), is necessary to replace all the factors related to age, including the tables of discrete data of spline functions original equations. Similarly, LLN can be expressed as LLN = c (age) xpredV to become a simple percentage of the predicted values, as a function of age. The equations with their respective new polynomial functions were validated in 52,764 consecutive spirometry tests performed in 2022 in 22,612 men and 30,152 women at the Cleveland Clinic. Using these equations, it become obvious that for both women and men, FEV1/FVC ratio decreases with the size as the exponent of the power function of height is lower for FEV1 than FVC. We conclude that rewriting the GLI predicted equations with simpler formulations restitutes to the GLI data some of their original allometric meaning, without altering the accuracy of their prediction.
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Affiliation(s)
- Philippe Haouzi
- Cleveland Clinic, Respiratory Institute, Department of Pulmonary Medicine, 9500 Euclid Avenue, Cleveland, OH 44195, United States.
| | - Sairam Raghavan
- Cleveland Clinic, Respiratory Institute, Department of Pulmonary Medicine, 9500 Euclid Avenue, Cleveland, OH 44195, United States
| | - Jonathan McCully
- Cleveland Clinic, Respiratory Institute, Department of Pulmonary Medicine, 9500 Euclid Avenue, Cleveland, OH 44195, United States
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Choi YJ, Park JH, Cho S, Park H, Kim S, Kwon E, Cho HI, Nah EH. Reference intervals of cell population data parameters in Sysmex XN-Series and its patterns of changes from early adulthood to geriatric ages in South Korea. Int J Lab Hematol 2024; 46:466-473. [PMID: 38263481 DOI: 10.1111/ijlh.14231] [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: 08/29/2023] [Accepted: 01/05/2024] [Indexed: 01/25/2024]
Abstract
INTRODUCTION Cell population data (CPD) parameters may be putative biomarkers for the screening of various diseases including some infections and myelodysplastic syndrome. This study aimed to establish the age- and sex-specific reference intervals (RIs) for the CPD parameters in the Korean population. METHODS The reference population for the RIs of CPD parameters comprised 124 856 subjects aged 20-99 years. CPD parameters were obtained from Sysmex XN-2000 (Kobe, Japan) datasets from 17 health promotion centers in 13 South Korean cities. We determined significant partitions for age and sex, and calculated RIs according to Clinical and Laboratory Standards Institute C28-A3 guidelines. RESULTS The side scattered light intensity in the neutrophil area and the lymphocyte area did not require sex-related partitioning except in those over the age of 50, among whom the lower limit (LL) and upper limit (UL) were lower in females. However, the side scattered light distribution width in the lymphocyte area required age- and sex-related partitioning, in which LL and UL were higher in females. The LL and UL of the fluorescent light distribution width were higher in males in the neutrophil area and higher in females in the lymphocyte area, but age-related partitioning was not required. The forward scattered light intensity in the neutrophil area, lymphocyte area, and monocyte area did not require age-related partitioning in males. CONCLUSION This study has determined comprehensive age- and sex-specific RIs for CPD parameters, which could help to prove the clinical significance of these parameters in the Sysmex XN-2000.
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Affiliation(s)
- Yong Jun Choi
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - Ju-Heon Park
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun, South Korea
| | - Seon Cho
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, South Korea
| | - Hyeran Park
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, South Korea
| | - Suyoung Kim
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, South Korea
| | - Eunjoo Kwon
- Health Promotion Research Institute, Korea Association of Health Promotion, Seoul, South Korea
| | - Han-Ik Cho
- MEDIcheck LAB, Korea Association of Health Promotion, Seoul, South Korea
| | - Eun-Hee Nah
- Department of Laboratory Medicine, Chonnam National University Hwasun Hospital, Hwasun, South Korea
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Wang YH, Sun L, Li SW, Wang CF, Pan XF, Liu Y, Wu J, Guan XP, Zhang SL, Zuo PF, Liu YL, Wang LY, Cui L, Liu Y, Lai YQ, Ding MY, Lu GL, Tan J, Yang XJ, Li YH, Zhang XT, Fan M, Yu JH, Zheng QJ, Ma CY, Ren WD. Left ventricular global longitudinal strain using a novel fully automated method: A head-to-head comparison with a manual layer-specific strain and establishment of normal reference ranges. Int J Cardiol 2024; 403:131886. [PMID: 38382850 DOI: 10.1016/j.ijcard.2024.131886] [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: 08/02/2023] [Revised: 12/28/2023] [Accepted: 02/18/2024] [Indexed: 02/23/2024]
Abstract
BACKGROUND A novel automated method for measuring left ventricular (LV) global longitudinal strain (GLS) along the endocardium has advantages in terms of its rapid application and excellent reproducibility. However, it remains unclear whether the available normal range for conventional GLS using the manual method is applicable to the automated GLS method. This study aimed to compare automated GLS head-to-head with manual layer-specific GLS, and to identify whether a specialized normal reference range for automated GLS is needed and explore the main determinants. METHODS In total, 1683 healthy volunteers (men, 43%; age, 18-80 years) were prospectively enrolled from 55 collaborating laboratories. LV GLS was measured using both manual layer-specific and automated methods. RESULTS Automated GLS was higher than endocardial, mid-myocardial, and epicardial GLS. Women had a higher automated GLS than men. GLS had no significant age dependency in men, but first increased and then decreased with age in women. Accordingly, sex- and age-specific normal ranges for automated GLS were proposed. Moreover, GLS appeared to have different burdens in relation to dominant determinants between the sexes. GLS in men showed no dominant determinants; however, GLS in women correlated with age, body mass index, and heart rate. CONCLUSIONS Using the novel automated method, was LV GLS higher than when using the manual GLS method. The normal ranges of automated GLS stratified according to sex and age were provided, with dominant determinants showing sex disparities that require full consideration in clinical practice.
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Affiliation(s)
- Yong-Huai Wang
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China
| | - Lu Sun
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shi-Wen Li
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China
| | - Chun-Feng Wang
- Department of Cardiovascular Ultrasound, Mineral Hospital of Liaoning Provincial Health Industry Group, Fushun, China
| | - Xiao-Fang Pan
- Department of Ultrasonic Medicine, Central Hospital of Dalian University of Technology, Dalian, China
| | - Ying Liu
- Department of Ultrasound, Zibo Municipal Hospital, Zibo, China
| | - Jun Wu
- Department of Cardiovascular Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xiang-Ping Guan
- Ultrasound Medical Center, ShanXi Province People's Hospital, Xi'an, China
| | - Su-Li Zhang
- Department of Cardiovascular Ultrasound, Chaoyang Central Hospital, Chaoyang, China
| | - Peng-Fei Zuo
- Department of Ultrasound Medicine, Baoji Central Hospital, Baoji, China
| | - Yi-Lin Liu
- Special Inspection Section, Liaocheng People's Hospital, Liaocheng, China
| | - Li-Yan Wang
- Department of Ultrasound, Jilin Central General Hospital, Jilin, China
| | - Lei Cui
- Department of Ultrasound Diagnosis, Xianyang Central Hospital, Xianyang, China
| | - Yan Liu
- Department of Ultrasound, Dali Bai Autonomous Prefecture People's Hospital, Dali, China
| | - Yu-Qiong Lai
- Depatment of Cardiovascular Ultrasound, The First People's Hospital of Foshan, Foshan, China
| | - Ming-Yan Ding
- Department of Cardiac Function, The People's Hospital of Liaoning Province, Shenyang, China
| | - Gui-Lin Lu
- Department of Ultrasound Diagnosis, The First Affiliated Hospital, School of Medicine, Shihezi University, Shihezi, China
| | - Jing Tan
- Department of Ultrasound in Medicine, Chengdu Wenjiang District People's Hospital, Chengdu, China
| | - Xin-Jian Yang
- Department of Ultrasound, The Second People's Hospital of Baiyin City, Baiyin, China
| | - Yi-Hong Li
- Department of Ultrasound, Tangshan Fengnan District Hospital, Tangshan, China
| | - Xin-Tong Zhang
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Miao Fan
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia-Hui Yu
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qiao-Jin Zheng
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
| | - Chun-Yan Ma
- Department of Cardiovascular Ultrasound, The First Hospital of China Medical University, Shenyang, China.
| | - Wei-Dong Ren
- Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang, China
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Doni D, Faraguna MC, Zannin E, Rinaldi A, Cafolla C, Iozzi L, Cavalleri V, Rigotti C, Sinelli M, Fedeli T, Ventura ML. Hemodynamic evaluation in preterm infants using ultrasonic cardiac output monitor (USCOM). Eur J Pediatr 2024; 183:2183-2192. [PMID: 38376594 DOI: 10.1007/s00431-024-05465-y] [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: 11/30/2023] [Revised: 01/22/2024] [Accepted: 01/31/2024] [Indexed: 02/21/2024]
Abstract
We aimed to establish reference ranges for USCOM parameters in preterm infants, determine factors that affect cardiac output, and evaluate the measurement repeatability. This retro-prospective study was performed at Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy. We included infants below 32 weeks of gestational age (GA) and/or 1500 g of birth weight (BW). We excluded infants with congenital heart diseases or hemodynamic instability. Measurements were performed at 3 ± 1, 7 ± 2, and 14 ± 2 postnatal days. We analyzed 204 measurements from 92 patients (median GA = 30.57 weeks, BW = 1360 g). The mean (SD) cardiac output (CO) was 278 (55) ml/min/kg, cardiac index (CI) was 3.1 (0.5) L/min/m2, and systemic vascular resistance (SVRI) was 1292 (294) d*s*cm-5/m2. CO presented a negative correlation with postmenstrual age (PMA), while SVRI presented a positive correlation with PMA. The repeatability coefficient was 31 ml/kg/min (12%). Conclusion: This is the first study describing reference values for USCOM parameters in hemodynamically stable preterm infants and factors affecting their variability. Further studies to investigate the usefulness of USCOM for the longitudinal assessment of patients at risk for cardiovascular instability or monitoring the response to therapies are warranted. What is Known: • The ultrasonic cardiac output monitoring (USCOM) has been widely used on adult and pediatric patients and reference ranges for cardiac output (CO) by USCOM have been established in term infants. What is New: • We established reference values for USCOM parameters in very preterm and very-low-birth-weight infants; the reference ranges for CO by USCOM in the study population were 198-405 ml/kg/min. • CO normalized by body weight presented a significant negative correlation with postmenstrual age (PMA); systemic vascular resistance index presented a significant positive correlation with PMA.
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Affiliation(s)
- Daniela Doni
- Neonatal Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori, Via Pergolesi 33, 20900, Monza, MB, Italy
| | | | - Emanuela Zannin
- Neonatal Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori, Via Pergolesi 33, 20900, Monza, MB, Italy.
| | - Alessandro Rinaldi
- Residency in Pediatrics, Università degli Studi Milano Bicocca, Milan, Italy
| | - Claudia Cafolla
- Residency in Pediatrics, Università degli Studi di Ferrara, Ferrara, Italy
| | - Lucia Iozzi
- Neonatal Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori, Via Pergolesi 33, 20900, Monza, MB, Italy
| | - Valeria Cavalleri
- Neonatal Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori, Via Pergolesi 33, 20900, Monza, MB, Italy
| | - Camilla Rigotti
- Neonatal Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori, Via Pergolesi 33, 20900, Monza, MB, Italy
| | - Mariateresa Sinelli
- Neonatal Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori, Via Pergolesi 33, 20900, Monza, MB, Italy
| | - Tiziana Fedeli
- Neonatal Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori, Via Pergolesi 33, 20900, Monza, MB, Italy
| | - Maria Luisa Ventura
- Neonatal Intensive Care Unit, Fondazione IRCCS San Gerardo dei Tintori, Via Pergolesi 33, 20900, Monza, MB, Italy
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Rogge AA, Liegl G, Snyder C, Rose M, Nolte S. EORTC QLQ-C30 general population normative data for the United States. Eur J Cancer 2024; 202:114030. [PMID: 38552543 DOI: 10.1016/j.ejca.2024.114030] [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: 12/19/2023] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVE The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 is a frequently used cancer-specific health-related quality of life (HRQoL) questionnaire. To aid interpretation of data obtained via EORTC QLQ-C30, general population norm data have been published for many countries. However, despite its frequent use in the United States, no normative data by sex and age exist to date. Therefore, this study aimed to generate sex- and age-specific EORTC QLQ-C30 normative data for the United States. METHODS Recruitment and data collection were carried out via online panels as part of a larger cross-sectional study. For the recruitment, the sample was stratified by sex and age (18-39, 40-49, 50-59, 60-69, ≥ 70 years) to achieve a balanced distribution, with n = 100 per subgroup. Descriptive statistics are presented by age and age/sex. RESULTS A total of N = 1009 respondents completed the survey (n = 508 females, n = 501 males). More than two thirds of participants (72.5%) reported at least one health condition, e.g., arthritis (26%). Across EORTC QLQ-C30 scales, women and men 60 years and older reported generally better/higher functioning and better/lower symptom scores compared to the younger age groups. CONCLUSION To date, no specific EORTC QLQ-C30 general population normative data have been published for the United States. This paper provides these important normative data, which will greatly support the interpretation of EORTC QLQ-C30 scale scores obtained from US cancer patients, and also enable comparison with European norms.
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Affiliation(s)
- Alizé A Rogge
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
| | - Gregor Liegl
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claire Snyder
- Johns Hopkins Schools of Medicine and Public Health, Baltimore, MD, USA
| | - Matthias Rose
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; German Centre for Mental Health (DZPG) - - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sandra Nolte
- Center for Patient-Centered Outcomes Research, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Psychosomatic Medicine, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Health Economics Unit, Centre for Health Policy, The University of Melbourne, Melbourne, VIC, Australia; School of Health Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
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Paddenberg E, Dees A, Proff P, Kirschneck C. Individual dental and skeletal age assessment according to Demirjian and Baccetti: Updated norm values for Central-European patients. J Orofac Orthop 2024; 85:199-212. [PMID: 36239773 PMCID: PMC11035409 DOI: 10.1007/s00056-022-00431-5] [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] [Received: 02/24/2022] [Accepted: 08/16/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Chronological age often differs from dental and skeletal age. With orthopantomograms and lateral cephalograms, dental and skeletal development can be determined according to the methods published by Demirjian et al. and Baccetti et al. However, gender and skeletal class as possible confounders were frequently not considered and available norm values are not up-to-date. This retrospective cross-sectional study thus aimed to evaluate effects of skeletal class and gender on dental and skeletal age of growing patients and to generate updated norm values for contemporary Central-European patients. METHODS A total of 551 patients were included in the dental and 733 in the skeletal age assessment, respectively. Dental analysis was based on tooth mineralisation stages in orthopantomograms (Demirjian) and skeletal age was defined by cervical vertebrae maturation stages (CVMS) in lateral cephalograms (Baccetti). Skeletal class was determined by the individualised ANB angle of Panagiotidis/Witt. With nonlinear regression analysis a formula for determining dental age was established. Effects of gender and skeletal class were evaluated and updated norm values generated. RESULTS Inter- and intrarater reliability tests revealed at least substantial measurement concordance for tooth mineralisation and CVMS. Demirjian stages and CVMS significantly depended on gender with girls developing earlier. Skeletal class significantly affected skeletal age only, but without clinical relevance. Updated norm values for dental age differed significantly from the original values of Demirjian and the values for skeletal age differed from those published by Baccetti. CONCLUSION Optimised norms, separated by gender, increase precision in determining individual dental and skeletal age during orthodontic treatment planning. Further studies analysing the effect of skeletal class on dental and skeletal development are needed.
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Affiliation(s)
- Eva Paddenberg
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany.
| | - Adrian Dees
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Peter Proff
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
| | - Christian Kirschneck
- Department of Orthodontics, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
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Messner A, Nairz J, Kiechl S, Winder B, Pechlaner R, Geiger R, Knoflach M, Kiechl-Kohlendorfer U. Comparison of body mass index and fat mass index to classify body composition in adolescents-The EVA4YOU study. Eur J Pediatr 2024; 183:2203-2214. [PMID: 38386029 PMCID: PMC11035421 DOI: 10.1007/s00431-024-05474-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/23/2024]
Abstract
The objectives of this study were to develop age- and sex-specific reference percentiles for fat mass index (FMI) and fat-free mass index (FFMI) in adolescents aged 14 to 19 years and to determine differences in overweight/obesity classification by FMI and body mass index (BMI). The EVA4YOU study is a single-center cross-sectional study conducted in western Austria. Cardiovascular risks including anthropometric measurements and bioelectrical impedance analysis were assessed in adolescents (mean age 17 years). FMI and FFMI were calculated as the ratio of fat mass (FM) and fat-free mass (FFM) to the square of height and compared to study population-specific BMI percentiles. One thousand four hundred twenty-two adolescents were included in the analysis. Girls had a significantly higher mean FM and FMI and a significantly lower mean FFM, FFMI (p < 0.001, each), and mean BMI (p = 0.020) than boys. Body composition classification by FMI and BMI percentiles shows a concordance for the < 75th and > 97th percentile, but a significant difference in percentile rank classifications between these two cut-off values (all p < 0.05). Based on FMI, 15.5% (221/1422) of the whole population and 29.4% (92/313) of those between the 75th and 97th percentiles are classified one category higher or lower than those assigned by BMI. CONCLUSION Classification of normal or pathologic body composition based on BMI and FMI shows good accordance in the clearly normal or pathologic range. In an intermediate range, FMI reclassifies categories based on BMI in more than a quarter of adolescents. Cut-off values to differentiate normal from pathologic FMI values on a biological basis are needed. TRIAL REGISTRATION The study is registered at www. CLINICALTRIALS gov (Identifier: NCT04598685; Date of registration: October 22, 2020). WHAT IS KNOWN • Chronic non-communicable diseases (NCDs) are the leading cause of morbidity and mortality globally, with major risk factors including unhealthy diets, harmful behaviors, and obesity. Obesity in children and adolescents is a key risk factor for later NCDs, which is commonly measured by Body Mass Index (BMI). • BMI can be misleading as it doesn't distinguish between fat mass (FM) and fat-free mass (FFM), leading to potential misclassification of obesity in children. Previous studies have already suggested the use of the Fat Mass Index (FMI) and Fat-Free Mass Index (FFMI) as a more accurate measures of body composition. WHAT IS NEW • This study adds the first age- and sex-specific reference values for FMI and FFMI in Austrian adolescents using bioelectrical impedance analysis (BIA) as a safe and secure measurement method of a large representative cohort. • We found percentile misclassification between BMI and FMI when categorizing for obesity, especially in intermediate categories of body composition. Furthermore, when comparing the new reference values for FMI and FFMI to existing ones from the US, UK, and Germany we could show a good alignment within the European cohorts and major differences with American values, indicating and confirming the difference of FMI and FFMI for different populations of different ethnical background, living on different continents.
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Affiliation(s)
- Alex Messner
- VASCage, Centre on Clinical Stroke Research, Innsbruck, Austria
- Department of Pediatrics II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Johannes Nairz
- VASCage, Centre on Clinical Stroke Research, Innsbruck, Austria
- Department of Pediatrics II, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
- Department of Pediatrics III, Medical University of Innsbruck, Innsbruck, Austria
| | - Sophia Kiechl
- VASCage, Centre on Clinical Stroke Research, Innsbruck, Austria
- Department of Neurology, Hochzirl Hospital, Zirl, Austria
| | - Bernhard Winder
- VASCage, Centre on Clinical Stroke Research, Innsbruck, Austria
- Department of Vascular Surgery, Feldkirch Hospital, Feldkirch, Austria
| | - Raimund Pechlaner
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Ralf Geiger
- Department of Pediatrics III, Medical University of Innsbruck, Innsbruck, Austria
| | - Michael Knoflach
- VASCage, Centre on Clinical Stroke Research, Innsbruck, Austria.
- Department of Neurology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
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10
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Karstens AJ, Christianson TJ, Lundt ES, Machulda MM, Mielke MM, Fields JA, Kremers WK, Graff-Radford J, Vemuri P, Jack CR, Knopman DS, Petersen RC, Stricker NH. Mayo normative studies: regression-based normative data for ages 30-91 years with a focus on the Boston Naming Test, Trail Making Test and Category Fluency. J Int Neuropsychol Soc 2024; 30:389-401. [PMID: 38014536 PMCID: PMC11014770 DOI: 10.1017/s1355617723000760] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
OBJECTIVE Normative neuropsychological data are essential for interpretation of test performance in the context of demographic factors. The Mayo Normative Studies (MNS) aim to provide updated normative data for neuropsychological measures administered in the Mayo Clinic Study of Aging (MCSA), a population-based study of aging that randomly samples residents of Olmsted County, Minnesota, from age- and sex-stratified groups. We examined demographic effects on neuropsychological measures and validated the regression-based norms in comparison to existing normative data developed in a similar sample. METHOD The MNS includes cognitively unimpaired adults ≥30 years of age (n = 4,428) participating in the MCSA. Multivariable linear regressions were used to determine demographic effects on test performance. Regression-based normative formulas were developed by first converting raw scores to normalized scaled scores and then regressing on age, age2, sex, and education. Total and sex-stratified base rates of low scores (T < 40) were examined in an older adult validation sample and compared with Mayo's Older Americans Normative Studies (MOANS) norms. RESULTS Independent linear regressions revealed variable patterns of linear and/or quadratic effects of age (r2 = 6-27% variance explained), sex (0-13%), and education (2-10%) across measures. MNS norms improved base rates of low performance in the older adult validation sample overall and in sex-specific patterns relative to MOANS. CONCLUSIONS Our results demonstrate the need for updated norms that consider complex demographic associations on test performance and that specifically exclude participants with mild cognitive impairment from the normative sample.
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Affiliation(s)
- Aimee J. Karstens
- Division of Neurocognitive Disorders, Department of
Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Teresa J. Christianson
- Division of Biomedical Statistics and Informatics,
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Emily S. Lundt
- Division of Biomedical Statistics and Informatics,
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Mary M. Machulda
- Division of Neurocognitive Disorders, Department of
Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michelle M. Mielke
- Department of Epidemiology and Prevention, Wake Forest
University School of Medicine, Winston-Salem, NC, USA
- Department of Gerontology and Geriatric Medicine, Wake
Forest University School of Medicine, Winston-Salem, NC, USA
| | - Julie A. Fields
- Division of Neurocognitive Disorders, Department of
Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Walter K. Kremers
- Division of Biomedical Statistics and Informatics,
Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | | | | | | | - Nikki H. Stricker
- Division of Neurocognitive Disorders, Department of
Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
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11
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Razvi S. Thyroid-function reference ranges in the diagnosis of thyroid dysfunction in adults. Nat Rev Endocrinol 2024; 20:253-254. [PMID: 38459379 DOI: 10.1038/s41574-024-00972-2] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Affiliation(s)
- Salman Razvi
- Translational and Clinical Research Institute, International Centre for Life, Newcastle University, Newcastle upon Tyne, UK.
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12
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Chen J, Sha L, Zhang X, Bao L, Li H, Zhao J, Xie G. Impact of sex and age on the lateralisation of the tibial tubercle in normal paediatric and adolescent populations. Knee Surg Sports Traumatol Arthrosc 2024; 32:1207-1215. [PMID: 38529701 DOI: 10.1002/ksa.12146] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 02/21/2024] [Accepted: 02/28/2024] [Indexed: 03/27/2024]
Abstract
PURPOSE Numerous methods have been proposed to characterise tubercle lateralisation. However, their normal values and related changes remain unclear. Accordingly, it was aimed to determine the potential sex and age effects and determined the optimal individualised method of diagnosing lateralisation of the tibial tubercle in patients with recurrent patellar dislocation (RPD). METHODS Measurements included the tibial tubercle-trochlear groove (TT-TG) distance, tibial tubercle-posterior cruciate ligament (TT-PCL) distance and tibial tubercle lateralisation (TTL); and the proximal tibial width (PTW), trochlear width (TW) and trochlear dysplasia index (TDI), for adjustment. A two-way analysis of variance was used to determine the effect of age, sex and their interaction within the normal group. When the age effect was statistically significant, a nonlinear regression was created. Areas under the receiver-operating characteristic curve (AUCs) were calculated to assess diagnostic accuracy. RESULTS A total of 277 normal participants (mean [SD] age, 13.5 [2.6] years; 125 [45.1%] female) and 227 patients with RPD (mean [SD] age, 13.5 [2.6] years; 161 [58.1%] female) were analysed. It was found that in the normal group, in patients aged 7-10, TT-PCL distance (p = 0.006), TTL (p = 0.007) and TT-PCL/PTW (p < 0.001) were significantly larger in females than in males. A significant sex effect was also detected on TT-TG/TW (p = 0.014). TT-TG distance, TT-PCL distance, TTL and TT-PCL/PTW (in male patients) approached an established normal adult value of 12.3 mm, 20.9 mm, 0.64 and 0.28, respectively, with increasing age (p < 0.001). The AUC was greater for TT-TG/TDI and TT-TG/TW (p ≤ 0.01) and TT-TG/TDI outperformed TT-TG/TW in patients aged 15-18 (p = 0.004). CONCLUSIONS Tubercle lateralisation increased with age and was affected by sex, with the exception of TT-TG distance and TT-TG/TDI. TT-TG/TDI is the optimal method of diagnosing a lateralized tibial tubercle in patients with RPD. These findings assist with the evaluation of tubercle lateralisation in that they provide a proper protocol for paediatric and adolescent populations with RPD; and thus, will help determine whether medial tubercle transfer should be included among the tailored surgical procedures considered for the treatment of patients with RPD. LEVEL OF EVIDENCE Level III.
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Affiliation(s)
- Jiebo Chen
- Department of Sports Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Sports Medicine, National Center for Orthopedics, Shanghai, China
| | - Lin Sha
- Department of Pediatric Orthopedics, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xueying Zhang
- Department of Sports Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Sports Medicine, National Center for Orthopedics, Shanghai, China
| | - Lei Bao
- Department of Radiology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hai Li
- Department of Pediatric Orthopedics, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinzhong Zhao
- Department of Sports Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Sports Medicine, National Center for Orthopedics, Shanghai, China
| | - Guoming Xie
- Department of Sports Medicine, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Sports Medicine, National Center for Orthopedics, Shanghai, China
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Clewell HJ, Fuchsman PC. Interspecies scaling of toxicity reference values in human health versus ecological risk assessments: A critical review. Integr Environ Assess Manag 2024; 20:749-764. [PMID: 37724480 DOI: 10.1002/ieam.4842] [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] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/08/2023] [Accepted: 09/07/2023] [Indexed: 09/20/2023]
Abstract
Risk assessments that focus on anthropogenic chemicals in environmental media-whether considering human health or ecological effects-often rely on toxicity data from experimentally studied species to estimate safe exposures for species that lack similar data. Current default extrapolation approaches used in both human health risk assessments and ecological risk assessments (ERAs) account for differences in body weight between the test organisms and the species of interest, but the two default approaches differ in important ways. Human health risk assessments currently employ a default based on body weight raised to the three-quarters power. Ecological risk assessments for wildlife (i.e., mammals and birds) are typically based directly on body weight, as measured in the test organism and receptor species. This review describes differences in the experimental data underlying these default practices and discusses the many factors that affect interspecies variability in chemical exposures. The interplay of these different factors can lead to substantial departures from default expectations. Alternative methodologies for conducting more accurate interspecies extrapolations in ERAs for wildlife are discussed, including tissue-based toxicity reference values, physiologically based toxicokinetic and/or toxicodynamic modeling, chemical read-across, and a system of categorical defaults based on route of exposure and toxic mode of action. Integr Environ Assess Manag 2024;20:749-764. © 2023 SETAC.
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Lupi A, Angelone R, Zinato S, Milone M, Vernuccio F, Crimì F, Quaia E, Pepe A. Atrial dimension reference values in healthy participants using the biplane/monoplane method for clinical and research use. Clin Radiol 2024; 79:393-398. [PMID: 38383253 DOI: 10.1016/j.crad.2024.01.024] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/09/2024] [Accepted: 01/16/2024] [Indexed: 02/23/2024]
Abstract
AIM To provide reference values of the dimensions of the left and right atrium (RA) obtained using the biplane and monoplane methods, respectively, on two- and four-chamber views, which represent the standard projections acquired in clinical practice, and correlation with body surface area (BSA), age, and gender. MATERIALS AND METHODS Healthy volunteers, M:F = 1:1, including five participants per gender and age decile from 20 to 70 years, who underwent cardiovascular magnetic resonance imaging (CMR) were enrolled prospectively. Normal atrial reference values were calculated for male and female subpopulations and stratified by age. Atrial areas and volumes were assessed both as absolute values and indexed to BSA. Differences among genders and correlation with age were assessed. Intra- and interobserver reproducibility were assessed in a subpopulation. RESULTS Fifty participants (mean age 43.3 ± 14 years, 25 men) were evaluated. Image analysis took <1 minute for each subject (mean time 30 ± 5 seconds). Intra- and interobserver reproducibility were excellent (ICC >0.85 for all datasets). RA areas were significantly higher in males (p=0.0001). The left atrial (LA) surface did not show significant differences among genders. Atrial areas normalised to BSA did not show significant gender differences. Both right and left absolute atrial volumes turned out to be significantly higher in males (p=0.0001 and p=0.0047, respectively), and normalised to BSA remained significantly different only for the RA (p=0.0006). Neither atrial volume nor areas showed significant correlation with age. CONCLUSIONS The monoplane method is a fast and reproducible technique to assess atrial dimensions. Absolute atrial dimensions show significant variations among genders. Gender-specific reference ranges for atrial dimensions are recommended.
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Affiliation(s)
- A Lupi
- Institute of Radiology, Department of Medicine - DIMED, Padova University Hospital, Padova, Italy
| | - R Angelone
- Institute of Radiology, Department of Medicine - DIMED, Padova University Hospital, Padova, Italy
| | - S Zinato
- Institute of Radiology, Department of Medicine - DIMED, Padova University Hospital, Padova, Italy
| | - M Milone
- Institute of Radiology, Department of Medicine - DIMED, Padova University Hospital, Padova, Italy
| | - F Vernuccio
- Institute of Radiology, Department of Medicine - DIMED, Padova University Hospital, Padova, Italy
| | - F Crimì
- Institute of Radiology, Department of Medicine - DIMED, Padova University Hospital, Padova, Italy
| | - E Quaia
- Institute of Radiology, Department of Medicine - DIMED, Padova University Hospital, Padova, Italy
| | - A Pepe
- Institute of Radiology, Department of Medicine - DIMED, Padova University Hospital, Padova, Italy.
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15
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Hodzelmans JJA, Janssen MLF, Reulen JPH, Blijham PJ, Koster A, Stehouwer CDA, Mess WH, Sutedja NA. Reference values for nerve conduction studies of the peroneal, tibial, and sural nerve derived from a large population-based cohort: Associations with demographic and anthropometric characteristics-The Maastricht study. Muscle Nerve 2024; 69:588-596. [PMID: 38459960 DOI: 10.1002/mus.28076] [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] [Received: 07/03/2023] [Revised: 02/23/2024] [Accepted: 02/27/2024] [Indexed: 03/11/2024]
Abstract
INTRODUCTION/AIMS Nerve conduction studies (NCSs) are widely used to support the clinical diagnosis of neuromuscular disorders. The aims of this study were to obtain reference values for peroneal, tibial, and sural NCSs and to examine the associations with demographic and anthropometric factors. METHODS In 5099 participants (aged 40-79 years) without type 2 diabetes of The Maastricht Study, NCSs of peroneal, tibial, and sural nerves were performed. Values for compound muscle action potential (CMAP) and sensory nerve action potential amplitude, nerve conduction velocity (NCV), and distal latency were acquired. The association of age, sex, body mass index (BMI), and height with NCS values was determined using uni- and multivariate linear regression analyses. RESULTS Detailed reference values are reported per decade for men and women. Significantly lower NCVs and longer distal latencies were observed in all nerves in older and taller individuals as well as in men. In these groups, amplitudes of the tibial and sural nerves were significantly lower, whereas a lower peroneal nerve CMAP was only significantly associated with age. BMI showed a multidirectional association. After correction for anthropometric factors in the multivariate analysis, the association between sex and NCS values was less straightforward. DISCUSSION These values from a population-based dataset could be used as a reference for generating normative values. Our findings show the association of NCS values with anthropometric factors. In clinical practice, these factors can be considered when interpreting NCS values.
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Affiliation(s)
- Jurriaan J A Hodzelmans
- Department of Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marcus L F Janssen
- Department of Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Jos P H Reulen
- Department of Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Paul J Blijham
- Department of Clinical Neurophysiology, Máxima Medical Center, Veldhoven, The Netherlands
| | - Annemarie Koster
- CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Department of Social Medicine, Maastricht University, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
- Department of Internal Medicine, Maastricht University, Maastricht, The Netherlands
| | - Werner H Mess
- Department of Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Nadia A Sutedja
- Department of Clinical Neurophysiology, Maastricht University Medical Center, Maastricht, The Netherlands
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16
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Cowper B, Lyle AN, Vesper HW, Van Uytfanghe K, Burns C. Standardisation and harmonisation of thyroid-stimulating hormone measurements: historical, current, and future perspectives. Clin Chem Lab Med 2024; 62:824-829. [PMID: 38295422 DOI: 10.1515/cclm-2023-1332] [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: 11/22/2023] [Accepted: 01/18/2024] [Indexed: 02/02/2024]
Abstract
Thyroid-stimulating hormone (TSH) is an important clinical marker in the diagnosis and management of thyroid disease. TSH measurements are reported in milli-International Units per Litre (mIU/L), traceable to a World Health Organisation (WHO) reference material. There is a wide variety of commercial immunoassays for TSH measurements available, which have historically been poorly harmonised due to a lack of commutability of the WHO reference materials with patient samples. This led to the recent development of a serum-based reference panel for TSH, traceable to the WHO reference material, available via the International Federation for Clinical Chemistry and Laboratory Medicine (IFCC), aimed at harmonisation of TSH immunoassays. This report describes recent developments in the TSH reference system, including establishment of the 4th WHO International Standard for TSH, and aims to clarify the relationship between the available reference materials and their intended uses. This 4th WHO IS is widely available and defines the unit of TSH activity, therefore its continued existence is of paramount importance, however it continues to show a lack of commutability with patient in many TSH immunoassays. This makes the C-STFT TSH panel, albeit available in restricted numbers, a critical resource to ensure better TSH assay harmonisation.
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Affiliation(s)
- Ben Cowper
- Medicines and Healthcare Products Regulatory Agency (MHRA), South Mimms, Hertfordshire, UK
| | - Alicia N Lyle
- Centers for Disease Control and Prevention, Division of Laboratory Sciences, Atlanta, GA, USA
| | - Hubert W Vesper
- Centers for Disease Control and Prevention, Division of Laboratory Sciences, Atlanta, GA, USA
| | | | - Chris Burns
- Medicines and Healthcare Products Regulatory Agency (MHRA), South Mimms, Hertfordshire, UK
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Vidali M, Giacchetti F, Sangiorgio A, Vantaggiato C, Rodari G, Orsenigo C, Di Modugno A, Napolitano F, Morniroli D, Colombo L, Profka E, Vizzari G, Mosca F, Ceriotti F, Mantovani G, Arosio M, Giannì ML, Giavoli C. Estimation of the reference values and decision limits for growth hormone in newborns using dried blood spots. Clin Chem Lab Med 2024; 62:939-945. [PMID: 37999718 DOI: 10.1515/cclm-2023-0972] [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: 09/03/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES Severe deficiency of growth hormone (GHD) of the newborn is a rare but potentially life-threatening disease. GH measured during the first week of life, using dried blood spots (DBS), may offer several advantages. Aim of the study was to estimate the reference values for GH in newborns by a new analytical method using DBS. METHODS Using a new developed analytical method, GH was estimated from DBS of 1,036 healthy newborns attending the Neonatology Unit of Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico of Milan in the period July-October 2021. Reference values for GH deficiency were estimated by the Harrell-Davis bootstrap method, with 90 %CI calculated by the bias-corrected and accelerated bootstrap method. RESULTS All GH measurements required 33 analytical sessions (8 months) with a CV% for calibration curve slopes equal to 6.9 %. Intermediate precision evaluated by measurement of low (3 μg/L) and high (10 μg/L) quality controls was, respectively, 14 and 6.5 %. GH reference values, estimated at percentiles 1.0st, 2.5th and 5.0th, and their 90 %CI, were, respectively, 4.5 μg/L (90 %CI 3.8-5.1), 5.9 μg/L (90 %CI 5.4-6.4) and 7.0 μg/L (90 %CI 6.7-7.3). GH levels were not associated with sex, standard deviation scores, birth weight, gestational age, type of delivery or mother's variables (age, smoking habit, gestational diabetes). CONCLUSIONS Validation data suggest that this method can be used to measured GH in newborns using DBS. The reference values estimated in this study are in accordance with previous published works using ELISA and may help confirming the clinical suspicion of neonatal GHD.
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Affiliation(s)
- Matteo Vidali
- Clinical Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Federico Giacchetti
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Chiara Vantaggiato
- Clinical Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulia Rodari
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Orsenigo
- Clinical Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Adriana Di Modugno
- Clinical Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Filomena Napolitano
- Clinical Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Daniela Morniroli
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Lorenzo Colombo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Eriselda Profka
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulia Vizzari
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
| | - Fabio Mosca
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Ferruccio Ceriotti
- Clinical Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanna Mantovani
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Maura Arosio
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Maria L Giannì
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, NICU, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Claudia Giavoli
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
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Kamath V, Chen H, Shrestha S, Mechanic-Hamilton D, Deal JA, Mosley TH, Schneider ALC. Normative Data for the 12-Item Sniffin' Sticks Odor Identification Test in Older Adults. Arch Clin Neuropsychol 2024; 39:335-346. [PMID: 37883325 DOI: 10.1093/arclin/acad080] [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: 09/26/2023] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE Quantitative olfactory assessment has demonstrated clinical utility for the evaluation of a range of neurologic, psychiatric, and sinonasal conditions. Here, we provide age, sex, race, and education-specific normative data for the 12-item Sniffin Sticks Odor Identification Test (SSOIT-12) in older Black and White U.S. adults without preclinical or clinical dementia or sinonasal disease. METHOD A sample of 2,224 Atherosclerosis Risk in Communities study participants aged 66-89 years were included. A normative regression equation was developed using a linear model for the association of age, sex, race, and education with odor identification score. Regression-based normative mean scores and percentiles were generated by age, sex, race, and education groups. RESULTS Participants (mean age = 74 years, 59% women, 20% Black, 48% > high school education) had a mean SSOIT-12 score of 9.8. Age, sex, race, and education were all associated with odor identification performance (all ps < .05). A linear regression model for the predicted SSOIT-12 score was developed for use with an individual's actual SSOIT-12 score in order to calculate the Z-score and corresponding percentile for a specific age, sex, race, and education group. Data are also reported in tabular format. CONCLUSIONS Our study provides SSOIT-12 normative data obtained from a large population of White and Black older adults without preclinical or clinical dementia or sinonasal disease living in the USA. These findings can aid clinicians in assessing the degree of olfactory loss, establishing concordance with a person's perception of olfactory difficulties and quantitatively monitoring changes in olfactory performance over time.
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Affiliation(s)
- Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Honglei Chen
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48824, USA
| | - Srishti Shrestha
- The Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Dawn Mechanic-Hamilton
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21287, USA
- Cochlear Center for Hearing and Public Health, Baltimore, MD 21287, USA
| | - Thomas H Mosley
- The Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, MS 39216, USA
| | - Andrea L C Schneider
- Department of Neurology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA
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delCacho-Tena A, Christ BR, Arango-Lasprilla JC, Perrin PB, Rivera D, Olabarrieta-Landa L. Normative Data Estimation in Neuropsychological Tests: A Systematic Review. Arch Clin Neuropsychol 2024; 39:383-398. [PMID: 37950923 DOI: 10.1093/arclin/acad084] [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] [Received: 03/02/2023] [Revised: 08/28/2023] [Accepted: 09/28/2023] [Indexed: 11/13/2023] Open
Abstract
OBJECTIVE To quantify the evolution, impact, and importance of normative data (ND) calculation by identifying trends in the research literature and what approaches need improvement. METHODS A PRISMA-guideline systematic review was performed on literature from 2000 to 2022 in PubMed, Pub-Psych, and Web of Science. Inclusion criteria included scientific articles about ND in neuropsychological tests with clear data analysis, published in any country, and written in English or Spanish. Cross-sectional and longitudinal studies were included. Bibliometric analysis was used to examine the growth, productivity, journal dispersion, and impact of the topic. VOSViewer compared keyword co-occurrence networks between 1952-1999 and 2000-2022. RESULTS Four hundred twelve articles met inclusion and exclusion criteria. The most studied predictors were age, education, and sex. There were a greater number of studies/projects focusing on adults than children. The Verbal Fluency Test (12.7%) was the most studied test, and the most frequently used variable selection strategy was linear regression (49.5%). Regression-based approaches were widely used, whereas the traditional approach was still used. ND were presented mostly in percentiles (44.2%). Bibliometrics showed exponential growth in publications. Three journals (2.41%) were in the Core Zone. VOSViewer results showed small nodes, long distances, and four ND-related topics from 1952 to 1999, and there were larger nodes with short connections from 2000 to 2022, indicating topic spread. CONCLUSIONS Future studies should be conducted on children's ND, and alternative statistical methods should be used over the widely used regression approaches to address limitations and support growth of the field.
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Affiliation(s)
- Ana delCacho-Tena
- Department of Health Science, Public University of Navarre, Pamplona, Navarre, Spain
| | - Bryan R Christ
- School of Data Science and Department of Psychology, University of Virginia, Charlottesville, VA, USA
| | | | - Paul B Perrin
- School of Data Science and Department of Psychology, University of Virginia, Charlottesville, VA, USA
| | - Diego Rivera
- Department of Health Science, Public University of Navarre, Pamplona, Navarre, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Laiene Olabarrieta-Landa
- Department of Health Science, Public University of Navarre, Pamplona, Navarre, Spain
- Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
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Issahaku S, Boadu M, Inkoom S, Hasford F, Sackey TA. Establishment and utilisation of national diagnostic reference level for adult computed tomography examinations in Ghana. Radiat Prot Dosimetry 2024; 200:564-571. [PMID: 38453140 DOI: 10.1093/rpd/ncae040] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 01/22/2024] [Accepted: 02/08/2024] [Indexed: 03/09/2024]
Abstract
The International Atomic Energy Agency, as part of the new regional project (RAF/9/059), recommend the establishment of diagnostic reference levels (DRLs) in Africa. In response to this recommendation, this project was designed to establish and utilise national DRLs of routine computed tomography (CT) examinations. These were done by estimating CT dose index and dose length product (DLP) from a minimum of 20 patient dose report of the most frequently used procedures using 75th percentile distribution of the median values. In all, 22 centres that formed 54% of all CT equipment in the country took part in this study. Additionally, a total of 2156 adult patients dose report were randomly selected, with a percentage distribution of 60, 12, 21 and 7% for head, chest, abdomen-pelvis and lumber spine, respectively. The established DRL for volume CT dose index were 60.0, 15.7, 20.5 and 23.8 mGy for head, chest, abdomen-pelvis and lumber spine, respectively. While the established DRL for DLP were 962.9, 1102.8, 1393.5 and 824.6 mGy-cm for head, chest, abdomen-pelvis, and lumber spine, respectively. These preliminary results were comparable with data from 16 other African countries, European Commission and the International Commission on Radiological Protection. Hence, this study would serve as a baseline for the establishment of a more generalised regional and national adult DRLs for Africa and other developing countries.
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Affiliation(s)
- Shiraz Issahaku
- Ghana Atomic Energy Commission, Medical Radiation Physics Center, Box LG 80, Legon, Accra, Ghana
- University of Ghana, Department of Medical Physics, Box LG 80, Legon, Accra, Ghana
| | - Mary Boadu
- Ghana Atomic Energy Commission, Medical Radiation Physics Center, Box LG 80, Legon, Accra, Ghana
- University of Ghana, Department of Medical Physics, Box LG 80, Legon, Accra, Ghana
| | - Stephen Inkoom
- Ghana Atomic Energy Commission, Medical Radiation Physics Center, Box LG 80, Legon, Accra, Ghana
- University of Ghana, Department of Medical Physics, Box LG 80, Legon, Accra, Ghana
| | - Francis Hasford
- Ghana Atomic Energy Commission, Medical Radiation Physics Center, Box LG 80, Legon, Accra, Ghana
- University of Ghana, Department of Medical Physics, Box LG 80, Legon, Accra, Ghana
| | - Theophilus A Sackey
- Ghana Atomic Energy Commission, Medical Radiation Physics Center, Box LG 80, Legon, Accra, Ghana
- University of Ghana, Department of Medical Physics, Box LG 80, Legon, Accra, Ghana
- Korle-Bu Teaching Hospital, Department of Radiology, PMB, Accra, Ghana
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21
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Taylor KA, Carroll MK, Short SA, Goode AP. Identifying characteristics and clinical conditions associated with hand grip strength in adults: the Project Baseline Health Study. Sci Rep 2024; 14:8937. [PMID: 38637523 PMCID: PMC11026445 DOI: 10.1038/s41598-024-55978-7] [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] [Received: 11/04/2022] [Accepted: 02/29/2024] [Indexed: 04/20/2024] Open
Abstract
Low hand grip strength (HGS) is associated with several conditions, but its value outside of the older adult population is unclear. We sought to identify the most salient factors associated with HGS from an extensive list of candidate variables while stratifying by age and sex. We used data from the initial visit from the Project Baseline Health Study (N = 2502) which captured detailed demographic, occupational, social, lifestyle, and clinical data. We applied MI-LASSO using group methods to determine variables most associated with HGS out of 175 candidate variables. We performed analyses separately for sex and age (< 65 vs. ≥ 65 years). Race was associated with HGS to varying degrees across groups. Osteoporosis and osteopenia were negatively associated with HGS in female study participants. Immune cell counts were negatively associated with HGS for male participants ≥ 65 (neutrophils) and female participants (≥ 65, monocytes; < 65, lymphocytes). Most findings were age and/or sex group-specific; few were common across all groups. Several of the variables associated with HGS in each group were novel, while others corroborate previous research. Our results support HGS as a useful indicator of a variety of clinical characteristics; however, its utility varies by age and sex.
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Affiliation(s)
- Kenneth A Taylor
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA.
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
| | | | | | - Adam P Goode
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, NC, USA
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA
- Duke University School of Medicine, Population Health Sciences, Durham, NC, USA
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22
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Strom JB, Mukherjee M, Beussink-Nelson L, Gardin JM, Freed BH, Shah SJ, Afilalo J. Reference Values for Indexed Echocardiographic Chamber Sizes in Older Adults: The Multi-Ethnic Study of Atherosclerosis. J Am Heart Assoc 2024; 13:e034029. [PMID: 38567667 DOI: 10.1161/jaha.123.034029] [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: 12/15/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Normalization of echocardiographic chamber measurements for body surface area may result in misclassification of individuals with obesity or sarcopenia. Normalization for alternative measures of body size may be preferable, but there remains a dearth of information on their normative values and association with cardiovascular function metrics. METHODS AND RESULTS A total of 3032 individuals underwent comprehensive 2-dimensional echocardiography at Exam 6 in MESA (Multi-Ethnic Study of Atherosclerosis). In the subgroup of 608 individuals free of cardiopulmonary disease (69.5±7.0 years, 46% male, 48% White, 17% Chinese, 15% Black, 21% Hispanic), normative values were derived for left and right cardiac chamber measurements across a variety of ratiometric (body surface area, body mass index, height) and allometric (height1.6, height2.7) scaling parameters. Normative upper and lower reference values were provided for each scaling parameter stratified across age groups, sex, and race or ethnicity. Among scaling parameters, body surface area and height were associated with the least variability across race and ethnicity categories and height2.7 was associated with the least variability across sex categories. CONCLUSIONS In this diverse cohort of community-dwelling older adults, we provide normative values for common echocardiographic parameters across a variety of indexation methods.
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Affiliation(s)
- Jordan B Strom
- Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center Harvard Medical School 375 Longwood Avenue, 4th Floor Boston MA USA
| | | | | | | | - Benjamin H Freed
- Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Sanjiv J Shah
- Northwestern University Feinberg School of Medicine Chicago IL USA
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23
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Dietzen DJ, Jackups R, Zaydman MA. Clinical implications of inaccurate potassium determination in hemolyzed pediatric blood specimens. Clin Chim Acta 2024; 557:117862. [PMID: 38460583 DOI: 10.1016/j.cca.2024.117862] [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: 01/03/2024] [Revised: 02/23/2024] [Accepted: 03/06/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND Analysis of whole blood specimens is rapid and saves blood, but hemolysis may go undetected and compromise the accuracy of potassium measurement. We aimed to define the frequency and magnitude of error in whole blood potassium measurement. METHODS 34 months of whole blood and plasma potassium data were extracted from patients aged less than 2 years at the time of sample acquisition. Hemolysis was detected using the plasma "H index." The magnitude of potassium bias was estimated from the difference between paired whole blood and plasma measurement separated by less than 2 h. RESULTS 56,000 of the 105,000 data points were from plasma and 20 % of these had significant hemolysis. Rates of hemolysis (nearing 50 %) were greatest in the neonatal nursery. Of 662 proximal whole blood and plasma paired results, 8 % had elevated whole blood potassium with a normal plasma value and 4 % had a normal whole blood potassium with reduced plasma potassium. The bias between whole blood and plasma potassium ranged from -1.0 to 4.0 mmol/L. CONCLUSIONS The use of whole blood analysis brings with it significant risk for error in potassium measurement. Better tools to detect hemolysis in these types of specimens are indicated.
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Affiliation(s)
- Dennis J Dietzen
- Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, United States; Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, United States.
| | - Ronald Jackups
- Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, United States
| | - Mark A Zaydman
- Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, United States
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Carvalho MDAR, Rosa LMT, Godinho JPM, Afonso M, Botero WG, de Oliveira LC. Comparative analysis of sediment quality indices using different reference values in an environmental protection area in Southeastern Brazil. Environ Geochem Health 2024; 46:154. [PMID: 38592573 DOI: 10.1007/s10653-024-01938-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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/23/2024] [Indexed: 04/10/2024]
Abstract
Contamination of aquatic ecosystems by potentially toxic elements (PTEs) is a concerning environmental issue, given their persistence, toxicity potential, and ability to accumulate in living organisms. Several studies have been conducted to assess the contamination of aquatic ecosystems by PTEs, using pollution and ecological risk indices that rely on the concentration of these elements in aquatic sediments. However, many of these studies use global reference values for calculating the indices, which can lead to misleading interpretations due to substantial variations in PTEs concentrations influenced by the geological characteristics of each region. Therefore, the use of regional reference values is more appropriate when available. This study aimed to investigate variations in the results of five indices, employing global, regional, and quality reference values, based on sediment samples collected from rivers in the Ipanema National Forest, a protected area in Brazil exposed to various anthropogenic pressures. The results revealed that elements such as Al, Fe, and Mn exceeded the limits allowed by legislation in water samples, while As and Cr surpassed the limits in sediment samples. Comparative analysis highlighted significant discrepancies in the results of the indices when global reference values were used compared to regional and quality reference values, especially for As and Ba. Thus, this study underscores the importance of establishing specific regional values for an accurate assessment of sediment quality and the risks associated with contamination by PTEs in different regions worldwide.
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Affiliation(s)
- Mayara de Almeida Ribeiro Carvalho
- Federal University of Sao Carlos, Sorocaba Campus, Graduate Program in Biotechnology and Environmental Monitoring, Sao Paulo, 18052-780, Brazil
| | - Luana Maria Tavares Rosa
- Federal University of Sao Carlos, Sorocaba Campus, Graduate Program in Biotechnology and Environmental Monitoring, Sao Paulo, 18052-780, Brazil
| | - João Paulo Mariano Godinho
- Federal University of Sao Carlos, Sorocaba Campus, Graduate Program in Biotechnology and Environmental Monitoring, Sao Paulo, 18052-780, Brazil
| | - Marcelo Afonso
- Ipanema National Forest, The Chico Mendes Institute for Biodiversity Conservation, Sao Paulo, 18190-000, Brazil
| | - Wander Gustavo Botero
- Graduate Program in Chemistry and Biotechnology, Federal University of Alagoas, Alagoas, 57072-900, Brazil
| | - Luciana Camargo de Oliveira
- Federal University of Sao Carlos, Sorocaba Campus, Graduate Program in Biotechnology and Environmental Monitoring, Sao Paulo, 18052-780, Brazil.
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Welarathna S, Velautham S, Sarasanandarajah S. Towards the establishment of national diagnostic reference levels for abdomen, KUB, and lumbar spine x-ray examinations in Sri Lanka: a multi-centric study. J Radiol Prot 2024; 44:021506. [PMID: 38537259 DOI: 10.1088/1361-6498/ad3837] [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] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/26/2024] [Indexed: 04/06/2024]
Abstract
Diagnostic reference levels (DRLs) and achievable doses (ADs) provide guidance to optimise radiation doses for patients undergoing medical imaging procedures. This multi-centre study aimed to compare institutional DRLs (IDRLs) across hospitals, propose ADs and multi-centric DRLs (MCDRLs) for four common x-ray examinations in Sri Lanka, and assess the potential for dose reduction. A prospective cross-sectional study of 894 adult patients referred for abdomen anteroposterior (AP), kidney-ureter-bladder (KUB) AP, lumbar spine AP, and lumbar spine lateral (LAT) x-ray examinations was conducted. Patient demographic information (age, sex, weight, BMI) and exposure parameters (tube voltage, tube current-exposure time product) were collected. Patient dose indicators were measured in terms of kerma-area product (PKA) using a PKAmeter. IDRLs, ADs, and MCDRLs were calculated following the International Commission on Radiological Protection guidelines, with ADs and MCDRLs defined as the 50th and 75th percentiles of the median PKAdistributions, respectively. IDRL ranges varied considerably across hospitals: 1.42-2.42 Gy cm2for abdomen AP, 1.51-2.86 Gy cm2for KUB AP, 0.83-1.65 Gy cm2for lumbar spine AP, and 1.76-4.10 Gy cm2for lumbar spine LAT. The proposed ADs were 1.82 Gy cm2(abdomen AP), 2.03 Gy cm2(KUB AP), 1.27 Gy cm2(lumbar spine AP), and 2.21 Gy cm2(lumbar spine LAT). MCDRLs were 2.24 Gy cm2(abdomen AP), 2.40 Gy cm2(KUB AP), 1.43 Gy cm2(lumbar spine AP), and 2.38 Gy cm2(lumbar spine LAT). Substantial intra- and inter-hospital variations in PKAwere observed for all four examinations. Although ADs and MCDRLs in Sri Lanka were comparable to those in the existing literature, the identified intra- and inter-hospital variations underscore the need for dose reduction without compromising diagnostic information. Hospitals with high IDRLs are recommended to review and optimise their practices. These MCDRLs serve as preliminary national DRLs, guiding dose optimisation efforts by medical professionals and policymakers.
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Affiliation(s)
- Sachith Welarathna
- Department of Physics, University of Peradeniya, Peradeniya 20400, Sri Lanka
- Postgraduate Institute of Science, University of Peradeniya, Peradeniya 20400, Sri Lanka
| | - Sivakumar Velautham
- Department of Physics, University of Peradeniya, Peradeniya 20400, Sri Lanka
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Mraz T, Asgari S, Karimi A, Breyer MK, Hartl S, Sunanta O, Ofenheimer A, Burghuber OC, Zacharasiewicz A, Lamprecht B, Schiffers C, Wouters EFM, Breyer-Kohansal R. Updated reference values for static lung volumes from a healthy population in Austria. Respir Res 2024; 25:155. [PMID: 38570835 PMCID: PMC10988832 DOI: 10.1186/s12931-024-02782-6] [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: 07/31/2023] [Accepted: 03/21/2024] [Indexed: 04/05/2024] Open
Abstract
BACKGROUND Reference values for lung volumes are necessary to identify and diagnose restrictive lung diseases and hyperinflation, but the values have to be validated in the relevant population. Our aim was to investigate the Global Lung Function Initiative (GLI) reference equations in a representative healthy Austrian population and create population-derived reference equations if poor fit was observed. METHODS We analysed spirometry and body plethysmography data from 5371 respiratory healthy subjects (6-80 years) from the Austrian LEAD Study. Fit with the GLI equations was examined using z-scores and distributions within the limits of normality. LEAD reference equations were then created using the LMS method and the generalized additive model of location shape and scale package according to GLI models. RESULTS Good fit, defined as mean z-scores between + 0.5 and -0.5,was not observed for the GLI static lung volume equations, with mean z-scores > 0.5 for residual volume (RV), RV/TLC (total lung capacity) and TLC in both sexes, and for expiratory reserve volume (ERV) and inspiratory capacity in females. Distribution within the limits of normality were shifted to the upper limit except for ERV. Population-derived reference equations from the LEAD cohort showed superior fit for lung volumes and provided reproducible results. CONCLUSION GLI lung volume reference equations demonstrated a poor fit for our cohort, especially in females. Therefore a new set of Austrian reference equations for static lung volumes was developed, that can be applied to both children and adults (6-80 years of age).
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Affiliation(s)
- Tobias Mraz
- Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Penzing, Sanatoriumstrasse 2, Vienna, 1140, Austria.
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria.
| | - Shervin Asgari
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
| | - Ahmad Karimi
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
| | - Marie-Kathrin Breyer
- Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Penzing, Sanatoriumstrasse 2, Vienna, 1140, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Sylvia Hartl
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
| | - Owat Sunanta
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
| | - Alina Ofenheimer
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
- School of Nutrition and Translational Research in Metabolism, NUTRIM, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Otto C Burghuber
- Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Penzing, Sanatoriumstrasse 2, Vienna, 1140, Austria
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
| | | | - Bernd Lamprecht
- Department of Pulmonology, Kepler University Hospital, Linz, Austria
- Medical Faculty, Johannes Kepler University, Linz, Austria
| | | | - Emiel F M Wouters
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Faculty of Medicine, Sigmund Freud Private University, Vienna, Austria
- School of Nutrition and Translational Research in Metabolism, NUTRIM, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Robab Breyer-Kohansal
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Department of Respiratory and Pulmonary Diseases, Vienna Healthcare Group, Clinic Hietzing, Vienna, Austria
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Ke P, Stidham RA, Castaneto MS, Forbes AM, Lewis JW, Wegner MD, Mont SL. Updated Adult Human Red Blood Cell Acetylcholinesterase Activity Reference Range with Time-Modified Michel Method. Clin Chem 2024; 70:680-682. [PMID: 38441310 DOI: 10.1093/clinchem/hvae012] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Affiliation(s)
- Pucheng Ke
- US Army Medical Department Southern Region Medical Command, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX 78234, United States
| | - Ralph A Stidham
- US Army Medical Department Southern Region Medical Command, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX 78234, United States
| | - Marisol S Castaneto
- US Army Medical Department Southern Region Medical Command, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX 78234, United States
| | - Adrienne M Forbes
- US Army Medical Department Southern Region Medical Command, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX 78234, United States
| | - Jeremy W Lewis
- US Army Medical Department Southern Region Medical Command, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX 78234, United States
| | - Matthew D Wegner
- US Army Medical Department Southern Region Medical Command, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX 78234, United States
| | - Stephanie L Mont
- US Army Medical Department Southern Region Medical Command, Joint Base San Antonio-Fort Sam Houston, San Antonio, TX 78234, United States
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28
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Mustafa MI, Ali IA, Mohammed MA, Taha EH, Awad KM, Musa OA. Reference intervals of complete blood count parameters in the adult western Sudanese population. BMC Res Notes 2024; 17:99. [PMID: 38566261 PMCID: PMC10988930 DOI: 10.1186/s13104-024-06754-3] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/25/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND A complete blood count (CBC) analysis is one of the most common conventional blood tests that physicians frequently prescribe. THE OBJECTIVE of this study was to determine the reference intervals (RIs) of CBC parameters in the population of healthy adults living in the western Sudan region. METHODS A cross-sectional study of healthy people residing in the western area of Sudan was carried out. We assessed the CBC RIs in samples taken from 153 individuals using an automated haematology analyser (Sysmex KX-21) and a modified Box-Cox transformation procedure to transform the data into a Gaussian distribution after eliminating outliers using the Dixon method. IBM SPSS Statistics version 25 was used to analyse the data, and t tests were employed to examine variations in the mean CBC parameters according to sex and age. P was considered significant at ≤ 0.05. RESULTS Beyond all the other measured values, the only CBC parameters that significantly differed between the sexes were haemoglobin (HGB) and white blood cell (WBC) counts. Women were found to experience more WBC counts than men did. However, they have less HGB RIs.The male participants in our study exhibited lower WBC count RIs, a significantly lower limit, and a greater upper limit of platelet RIs than did the individuals from other nations. CONCLUSIONS Compared with males, females had higher platelet and WBC counts and lower HGB.
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Affiliation(s)
- Malak Ibrahim Mustafa
- Department of Physiology, Faculty of Medicine, The National Ribat University, Khartoum, Sudan
| | - Ibrahim Abdelrhim Ali
- Department of Physiology, Faculty of Medicine, The National Ribat University, Khartoum, Sudan
| | - Muaath Ahmed Mohammed
- Department of Physiology, Faculty of Medicine, The National Ribat University, Khartoum, Sudan.
| | - Elmutaz Hussien Taha
- Department of Physiology, Faculty of Medicine, University of Dongola, Dongola, Sudan
| | - Kamal Mohamed Awad
- Department of Physiology, Faculty of Medicine, University of Gadarif, Elgadarif, Sudan
| | - Omer Abdelaziz Musa
- Department of Physiology, Faculty of Medicine, The National Ribat University, Khartoum, Sudan
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Pimenta A, Azevedo L, Ramos I, Santos J. Establishment of Diagnostic Reference Levels in Portuguese Interventional Radiology departments. Eur J Radiol 2024; 173:111377. [PMID: 38382425 DOI: 10.1016/j.ejrad.2024.111377] [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: 10/12/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE To establish Portuguese Diagnostic Reference Levels (DRLs), for six body fluoroscopy guided interventional procedures (FGIP). METHOD A retrospective study was conducted in five interventional departments most representative of Interventional Radiology (IR) practice. Dose values, in terms of air kerma area product (PKA in Gy.cm2), air kerma at the patient entrance reference point (Ka,r in mGy), and exposure parameters (fluoroscopy time (FT) and number of cine runs) were collected. Examinations were selected per procedure (at least 20), according to the antero-posterior and lateral diameter mean value (±5 cm), measured on previous Computed Tomography (CT) examinations. RESULTS Data of 489 body FGIP show a large variation on dose values per procedure and per department. National DRLs in terms of PKA were 20.2 Gy.cm2 for Percutaneous transhepatic biliary drainage (PTBD), 98.2 Gy.cm2 for Bronchial artery embolisation (BAE), 247.7 Gy.cm2 for Transarterial chemoembolisation (TACE), 331.6 Gy.cm2 for Inferior epigastric arteries embolisation (IEAE), 312.0 Gy.cm2 for Transjugular intrahepatic portosystemic shunt (TIPS) and 19.3 Gy.cm2 for Endovascular treatment of femoral popliteal arteries (ETFPA). CONCLUSIONS This is the first study reporting Interventional Radiology DRLs in Portugal and we propose preliminary national estimates for the six more common body FGIP. The results of this study will be presented and discussed with all Portuguese IR departments, to promote procedures optimisation.
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Affiliation(s)
- Andrea Pimenta
- University Hospital of St. John (CHUSJ), Radiology Department - Porto, Portugal.
| | - Luís Azevedo
- CINTESIS@RISE Department of Community, Information and Health Decision Sciences- MEDCIDS, Faculty of Medicine University of Porto, Porto, Portugal.
| | | | - Joana Santos
- Instituto Politécnico de Coimbra, ESTESC - Coimbra Health School, Medical Imaging and Radiotherapy, Portugal.
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Song Y, Chang L, Lun Y, Chen C, Fu R, Wang D, Zhou C. Analysis of Factors Affecting Concentrations and Concentration-To-Dose Ratios of Trazodone. Ther Drug Monit 2024; 46:252-258. [PMID: 38287895 DOI: 10.1097/ftd.0000000000001178] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 11/21/2023] [Indexed: 01/31/2024]
Abstract
BACKGROUND Trazodone is prescribed for several clinical conditions. Multiple factors may affect trazodone to reach its therapeutic reference range. The concentration-to-dose (C/D) ratio can be used to facilitate the therapeutic drug monitoring of trazodone. The study aimed to investigate factors on the concentrations and C/D ratio of trazodone. METHODS This study analyzed the therapeutic drug monitoring electronic case information of inpatients in the First Hospital of Hebei Medical University from October 2021 to July 2023. Factors that could affect the concentrations and C/D ratio of trazodone were analyzed, including body mass index, sex, age, smoking, drinking, drug manufacturers, and concomitant drugs. RESULTS A total of 255 patients were analyzed. The mean age was 52.44 years, and 142 (55.69%) were women. The mean dose of trazodone was 115.29 mg. The mean concentration of trazodone was 748.28 ng/mL, which was in the therapeutic reference range (700-1000 ng/mL). 50.20% of patients reached the reference range, and some patients (36.86%) had concentrations below the reference range. The mean C/D ratio of trazodone was 6.76 (ng/mL)/(mg/d). A significant positive correlation was found between daily dose and trazodone concentrations (r 2 = 0.2885, P < 0.001). Trazodone concentrations were significantly affected by dosage, sex, smoking, drinking, and concomitant drugs of duloxetine or fluoxetine. After dosage emendation, besides the above factors, it was influenced by age ( P < 0.05, P < 0.01, or P < 0.001). CONCLUSIONS This study identified factors affecting trazodone concentrations and C/D ratio. The results can help clinicians closely monitor patients on trazodone therapy and maintain concentrations within the reference range.
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Affiliation(s)
- Yang Song
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, China; and
| | - Luyao Chang
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, China; and
| | - Yang Lun
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, China; and
| | - Chaoli Chen
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, China; and
| | - Ran Fu
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, China; and
| | - Donghan Wang
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, China; and
| | - Chunhua Zhou
- Department of Clinical Pharmacy, The First Hospital of Hebei Medical University, Shijiazhuang, China; and
- Department of the Technology Innovation Center for Artificial Intelligence in Clinical Pharmacy of Hebei Province, the First Hospital of Hebei Medical University, Shijiazhuang, China
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Sattaf F, Scherf-Clavel M, Unterecker S, Reif A, Hahn M. Recommendation for a Therapeutic Reference Range of Cariprazine-A Short Communication. Ther Drug Monit 2024; 46:270-273. [PMID: 38018849 DOI: 10.1097/ftd.0000000000001152] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 09/19/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND Therapeutic reference ranges are essential for therapeutic drug monitoring to evaluate results and adjust pharmacotherapy. The measured serum concentrations of cariprazine-treated patients have frequently been found to lie beyond the currently used therapeutic reference range; furthermore, reliable data for establishing evidence-based therapeutic ranges are scarce. The current therapeutic reference ranges have only been estimated; however, real-world data on cariprazine are missing. Individual serum concentrations were analyzed, and the validity of the currently used reference ranges was assessed. METHODS Serum concentrations of 19 psychiatric patients treated with cariprazine without pharmacokinetic abnormalities were retrospectively analyzed. Only the last measurement per patient was included in the analysis, and patients who underwent a dose adjustment in the subsequent 2 weeks after sampling were excluded (assuming that the target dose and response had been achieved at that time). Serum concentrations were compared with the therapeutic reference range (10-20 ng/mL) of the Arbeitsgemeinschaft für Neuropsychiatrie und Pharmakotherapie consensus guidelines of 2017 and with a recent recommendation for a lower therapeutic reference range (5-15 ng/mL). RESULTS The mean serum concentration was 9.1 ± 4.1 SD ng/mL. A total of 47.4% of the values were within the therapeutic reference range of 10-20 ng/mL, and 78.9% fell within the range of 5-15 ng/mL. CONCLUSIONS These results support previous recommendations for lowering the therapeutic reference range to 5-15 ng/mL. The calculated therapeutic reference range was 5.0-13.2 ng/mL. It may even be potentially lower because clinicians may have tried to titrate the dose to a serum concentration within the current therapeutic reference range of 10-20 ng/mL.
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Affiliation(s)
- Fabian Sattaf
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Frankfurt am Main
| | - Maike Scherf-Clavel
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg; and
| | - Stefan Unterecker
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Würzburg; and
| | - Andreas Reif
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Frankfurt am Main
| | - Martina Hahn
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Frankfurt am Main
- Department of Mental Health, Varisano Hospital Frankfurt Hoechst, Frankfurt am Main, Germany
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Jantarasaengaram S, Jaisamut P, Yanaranop M, Sriswasdi S. Spectral Doppler Parameters of Fetal Main Branch Pulmonary Artery at 20 to 40 Weeks of Gestation: Reference Ranges and Percentile Calculators. J Am Soc Echocardiogr 2024; 37:439-448. [PMID: 38040062 DOI: 10.1016/j.echo.2023.11.023] [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: 08/31/2023] [Revised: 11/21/2023] [Accepted: 11/21/2023] [Indexed: 12/03/2023]
Abstract
BACKGROUND The published reference ranges for Doppler parameters of the fetal pulmonary artery (PA) are usually derived from small sample sizes with no practical standard score or percentile ranking, which hinders systematic comparisons of Doppler figures across different gestational ages (GAs). This study aimed to establish comprehensive reference ranges and provide a percentile ranking solution for key spectral Doppler parameters. METHODS This is a cross-sectional study of 465 uncomplicated singleton pregnancies during 20 to 40 weeks of gestation. Spectral waveforms of the fetal main branch PA were obtained with a pulsed-wave Doppler interrogation site within 5 mm from the vascular origin. Fifteen spectral Doppler parameters were identified. Associations between these parameters with GA and fetal heart rate were assessed and used to develop percentile calculators via different statistical models. The root mean squared error of each model was calculated to determine the best performance solution. RESULTS Acceptable spectral waveforms were obtained for 94.1% (438/465) of the fetuses. All Doppler parameters except pulsatility index, manually traced pulsatility index, peak systolic velocity, and time to systolic notch/acceleration time ratio were significantly correlated with GA, while acceleration time, ejection time, time to systolic notch, peak early-diastolic reversal flow, and peak early-diastolic reversal flow/peak systolic velocity ratio were additionally significantly correlated with fetal heart rate. Support vector machine models with radial basis kernel yield the best percentile estimation (root mean squared error of 2.17-4.08 and R2 of >0.98). Furthermore, the top 5% and bottom 5% outliers could be identified with positive predictive values of 0.71 to 0.97. An online user interface of percentile calculators is available at https://github.com/cmb-chula/fetoPAD. CONCLUSIONS This study presents normal reference ranges and percentile calculators for 15 spectral Doppler parameters of the fetal main branch PA, some of which have not been published. The estimated percentiles enhance comparison and outlier detection of the spectral Doppler figures among fetuses at different GAs.
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Affiliation(s)
- Surasak Jantarasaengaram
- Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand.
| | - Pemika Jaisamut
- Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
| | - Marut Yanaranop
- Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
| | - Sira Sriswasdi
- Center of Excellence in Computational Molecular Biology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Center for Artificial Intelligence in Medicine, Research Affairs, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Palumbo L, Caron S, Ballouard JM, Bonnet X, Ramery E, Gilot-Fromont E, Larrat S. Reduce, Replace, Refine: Determining A Posteriori Reference Intervals for Biochemistry in Hermann's Tortoise (Testudo hermanni). J Wildl Dis 2024; 60:502-506. [PMID: 38268240 DOI: 10.7589/jwd-d-23-00065] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 10/24/2023] [Indexed: 01/26/2024]
Abstract
Biochemical and hematological analyses are important for the assessment of animal health. However, for most wild species their use is hindered by the scarcity of reliable reference intervals. Indeed, collecting body fluids (e.g., blood, urine) in free-ranging animals is often technically challenging. Further, sampling many individuals would be essential to consider major sources of variations, such as species, populations, sex, age, and seasons. One alternative, according to the reduction, refinement, and replacement framework, is to establish reference intervals a posteriori using literature survey and unpublished data. We produced reference intervals for free-ranging Hermann's tortoises (Testudo hermanni), using analyses performed on blood samples collected in previous studies and conservation programs conducted in the field between 2010 and 2016 in southern France (n=195 individuals). Thirteen parameters were analyzed: packed-cell volume, blood concentrations of corticosterone, testosterone, glycemia, cholesterol, triglyceride, urea, uric acid, calcium, sodium, potassium, asparagine aminotransferase (AST), and alanine aminotransferases (ALT). Reference intervals for subgroups defined by sex and season were relevant for corticosterone, triglyceride, and calcium (sex) and cholesterol (season). Comparing our results with those obtained in captive individuals in Germany, except for urea and AST levels the intervals from both free-ranging versus captive tortoises were similar, suggesting that reference intervals established from captive individuals may be suitable for free-ranging populations in this species.
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Affiliation(s)
- Loïc Palumbo
- Pôle EVAAS, VetAgro Sup, 1 avenue de Bourgelat 69280 Marcy-l'Étoile, France
- Office français de la biodiversité, DRAS, 9 avenue Buffon 45100 Orléans, France
| | - Sébastien Caron
- Station d'Observation et de Protection des Tortues et leurs Milieux, 1065 route du Luc 83660 Carnoules, France
| | - Jean-Marie Ballouard
- Station d'Observation et de Protection des Tortues et leurs Milieux, 1065 route du Luc 83660 Carnoules, France
| | - Xavier Bonnet
- Centre d'Etudes Biologiques de Chizé, UMR-7372, CNRS-La Rochelle Université, 405 route de Prissé la Charrière 79360 Villiers-en-Bois, France
| | - Eve Ramery
- Pôle EVAAS, VetAgro Sup, 1 avenue de Bourgelat 69280 Marcy-l'Étoile, France
| | | | - Sylvain Larrat
- Pôle EVAAS, VetAgro Sup, 1 avenue de Bourgelat 69280 Marcy-l'Étoile, France
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Aung N, Bartoli A, Rauseo E, Cortaredona S, Sanghvi MM, Fournel J, Ghattas B, Khanji MY, Petersen SE, Jacquier A. Left Ventricular Trabeculations at Cardiac MRI: Reference Ranges and Association with Cardiovascular Risk Factors in UK Biobank. Radiology 2024; 311:e232455. [PMID: 38563665 DOI: 10.1148/radiol.232455] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background The extent of left ventricular (LV) trabeculation and its relationship with cardiovascular (CV) risk factors is unclear. Purpose To apply automated segmentation to UK Biobank cardiac MRI scans to (a) assess the association between individual characteristics and CV risk factors and trabeculated LV mass (LVM) and (b) establish normal reference ranges in a selected group of healthy UK Biobank participants. Materials and Methods In this cross-sectional secondary analysis, prospectively collected data from the UK Biobank (2006 to 2010) were retrospectively analyzed. Automated segmentation of trabeculations was performed using a deep learning algorithm. After excluding individuals with known CV diseases, White adults without CV risk factors (reference group) and those with preexisting CV risk factors (hypertension, hyperlipidemia, diabetes mellitus, or smoking) (exposed group) were compared. Multivariable regression models, adjusted for potential confounders (age, sex, and height), were fitted to evaluate the associations between individual characteristics and CV risk factors and trabeculated LVM. Results Of 43 038 participants (mean age, 64 years ± 8 [SD]; 22 360 women), 28 672 individuals (mean age, 66 years ± 7; 14 918 men) were included in the exposed group, and 7384 individuals (mean age, 60 years ± 7; 4729 women) were included in the reference group. Higher body mass index (BMI) (β = 0.66 [95% CI: 0.63, 0.68]; P < .001), hypertension (β = 0.42 [95% CI: 0.36, 0.48]; P < .001), and higher physical activity level (β = 0.15 [95% CI: 0.12, 0.17]; P < .001) were associated with higher trabeculated LVM. In the reference group, the median trabeculated LVM was 6.3 g (IQR, 4.7-8.5 g) for men and 4.6 g (IQR, 3.4-6.0 g) for women. Median trabeculated LVM decreased with age for men from 6.5 g (IQR, 4.8-8.7 g) at age 45-50 years to 5.9 g (IQR, 4.3-7.8 g) at age 71-80 years (P = .03). Conclusion Higher trabeculated LVM was observed with hypertension, higher BMI, and higher physical activity level. Age- and sex-specific reference ranges of trabeculated LVM in a healthy middle-aged White population were established. © RSNA, 2024 Supplemental material is available for this article. See also the editorial by Kawel-Boehm in this issue.
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Affiliation(s)
- Nay Aung
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Axel Bartoli
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Elisa Rauseo
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Sebastien Cortaredona
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Mihir M Sanghvi
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Joris Fournel
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Badih Ghattas
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Mohammed Y Khanji
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Steffen E Petersen
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
| | - Alexis Jacquier
- From the Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, England (N.A., E.R., M.M.S., M.Y.K., S.E.P.); Department of Radiology, Hôpital de la Timone, AP-HM, 264 rue Saint-Pierre, 13385 Marseille CEDEX 05, France (A.B., A.J.); Center for Magnetic Resonance in Biology and Medicine, UMR CNRS 7339, Aix-Marseille University, Marseille, France (A.B., J.F., A.J.); Institut de Recherche pour le Developpement, VITROME, Aix-Marseille University, Marseille, France (S.C.); Aix-Marseille School of Economics, Aix-Marseille University, Marseille, France (B.G.); Newham University Hospital, Barts Health NHS Trust, London, England (M.Y.K.); Health Data Research UK, London, England (S.E.P.); and Alan Turing Institute, London, England (S.E.P.)
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Stritzke A, Ismail R, Rose MS, Lyon AW, Fenton TR. Cord-Blood Derived Chemistry Reference Values in Preterm Infants for Sodium, Chloride, Potassium, Glucose, and Creatinine. Am J Perinatol 2024; 41:722-729. [PMID: 34983069 DOI: 10.1055/a-1730-8536] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE International guidelines recommend that preterm infants should be supported to maintain their serum electrolytes within "normal" ranges. In term babies, cord blood values differed in pathological pregnancies from healthy ones. STUDY DESIGN We examined cord blood sodium, chloride, potassium, glucose, and creatinine to derive maturity-related reference intervals. We examined associations with gestational age, delivery mode, singleton versus multiple, and prenatal maternal adverse conditions. We compared preterm cord values to term, and to adult reference ranges. RESULTS There were 591 infants, 537 preterm and 54 term. Preterm cord glucose levels were steady (3.7 ± 1.1 mmol/L), while sodium, chloride, and creatinine increased over GA by 0.17, 0.14 mmol/L/week, and 1.07 µmol/L/week, respectively (p < 0.003). Average preterm cord potassium and chloride were higher than the term (p < 0.05). Compared with adult reference intervals, cord preterm reference intervals were higher for chloride (100-111 vs. 98-106 mmol/L), lower for creatinine (29-84 vs. 62-115 µmol/L), and more variable for potassium (2.7-7.9 vs. 3.5-5.0 mmol/L) and sodium (130-141 vs. 136-145 mmol/L). Cesarean section was associated with higher potassium and lower glucose, multiple births with higher chloride and creatinine and lower glucose, and SGA with lower glucose. CONCLUSION Cord blood values varied across the GA range with increases in sodium, chloride, and creatinine, while glucose remained steady. Average preterm reference values were higher than term values for potassium and chloride. Preterm reference values differed from published adults' reference values. The changes across GA and by delivery mode, SGA, and being a multiple, which may have direct implications for neonatal care and fluid management. KEY POINTS · Cord blood electrolyte, creatinine, and glucose values vary across neonatal gestational age.. · Average preterm cord values of potassium and chloride were higher than term values.. · Cord reference values differ by delivery mode, growth, and multiple impacting neonatal care decisions..
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Affiliation(s)
- Amelie Stritzke
- Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
| | - Rana Ismail
- Section of Neonatology, Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - M Sarah Rose
- Research Excellence Support Team, Alberta Health Services, Calgary, Calgary, Canada
| | - Andrew W Lyon
- Pathology and Laboratory Medicine, Saint Pauls Hospital Laboratory, Saskatoon, Saskatchewan, Canada
| | - Tanis R Fenton
- Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
- Community Health Sciences, University of Calgary, Calgary, Canada
- Nutrition Services, Alberta Health Services, Calgary, Canada
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Weston AD, Grossardt BR, Garner HW, Kline TL, Chamberlain AM, Allen AM, Erickson BJ, Rocca WA, Rule AD, St. Sauver JL. Abdominal Body Composition Reference Ranges and Association With Chronic Conditions in an Age- and Sex-Stratified Representative Sample of a Geographically Defined American Population. J Gerontol A Biol Sci Med Sci 2024; 79:glae055. [PMID: 38373180 PMCID: PMC10949446 DOI: 10.1093/gerona/glae055] [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] [Received: 05/10/2023] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Body composition can be accurately quantified from abdominal computed tomography (CT) exams and is a predictor for the development of aging-related conditions and for mortality. However, reference ranges for CT-derived body composition measures of obesity, sarcopenia, and bone loss have yet to be defined in the general population. METHODS We identified a population-representative sample of 4 900 persons aged 20 to 89 years who underwent an abdominal CT exam from 2010 to 2020. The sample was constructed using propensity score matching an age and sex stratified sample of persons residing in the 27-county region of Southern Minnesota and Western Wisconsin. The matching included race, ethnicity, education level, region of residence, and the presence of 20 chronic conditions. We used a validated deep learning based algorithm to calculate subcutaneous adipose tissue area, visceral adipose tissue area, skeletal muscle area, skeletal muscle density, vertebral bone area, and vertebral bone density from a CT abdominal section. RESULTS We report CT-based body composition reference ranges on 4 649 persons representative of our geographic region. Older age was associated with a decrease in skeletal muscle area and density, and an increase in visceral adiposity. All chronic conditions were associated with a statistically significant difference in at least one body composition biomarker. The presence of a chronic condition was generally associated with greater subcutaneous and visceral adiposity, and lower muscle density and vertebrae bone density. CONCLUSIONS We report reference ranges for CT-based body composition biomarkers in a population-representative cohort of 4 649 persons by age, sex, body mass index, and chronic conditions.
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Affiliation(s)
- Alexander D Weston
- Digital Innovation Lab, Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, Florida, USA
| | - Brandon R Grossardt
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Hillary W Garner
- Division of Musculoskeletal Radiology, Department of Radiology, Mayo Clinic, Jacksonville, Florida, USA
| | - Timothy L Kline
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Alanna M Chamberlain
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Alina M Allen
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Bradley J Erickson
- Mayo Artificial Intelligence Laboratory, Department of Radiology, Mayo Clinic, Rochester Minnesota, USA
| | - Walter A Rocca
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Andrew D Rule
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
- Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Jennifer L St. Sauver
- Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
- The Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
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Hijleh AA, Wang S, Berton DC, Neder-Serafini I, Vincent S, James M, Domnik N, Phillips D, Nery LE, O'Donnell DE, Neder JA. Reference values for leg effort during incremental cycle ergometry in non-trained healthy men and women, aged 19-85. Scand J Med Sci Sports 2024; 34:e14625. [PMID: 38597357 DOI: 10.1111/sms.14625] [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: 11/16/2023] [Revised: 03/19/2024] [Accepted: 03/24/2024] [Indexed: 04/11/2024]
Abstract
Heightened sensation of leg effort contributes importantly to poor exercise tolerance in patient populations. We aim to provide a sex- and age-adjusted frame of reference to judge symptom's normalcy across progressively higher exercise intensities during incremental exercise. Two-hundred and seventy-five non-trained subjects (130 men) aged 19-85 prospectively underwent incremental cycle ergometry. After establishing centiles-based norms for Borg leg effort scores (0-10 category-ratio scale) versus work rate, exponential loss function identified the centile that best quantified the symptom's severity individually. Peak O2 uptake and work rate (% predicted) were used to threshold gradually higher symptom intensity categories. Leg effort-work rate increased as a function of age; women typically reported higher scores at a given age, particularly in the younger groups (p < 0.05). For instance, "heavy" (5) scores at the 95th centile were reported at ~200 W (<40 years) and ~90 W (≥70 years) in men versus ~130 W and ~70 W in women, respectively. The following categories of leg effort severity were associated with progressively lower exercise capacity: ≤50th ("mild"), >50th to <75th ("moderate"), ≥75th to <95th ("severe"), and ≥ 95th ("very severe") (p < 0.05). Although most subjects reporting peak scores <5 were in "mild" range, higher scores were not predictive of the other categories (p > 0.05). This novel frame of reference for 0-10 Borg leg effort, which considers its cumulative burden across increasingly higher exercise intensities, might prove valuable to judging symptom's normalcy, quantifying its severity, and assessing the effects of interventions in clinical populations.
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Affiliation(s)
- Abed A Hijleh
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Sophia Wang
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Danilo C Berton
- Pulmonary Function Tests Laboratory, Federal University of Rio Grande to Sul, Porto Alegre, RS, Brazil
| | - Igor Neder-Serafini
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Sandra Vincent
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Matthew James
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Nicolle Domnik
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Devin Phillips
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, Ontario, Canada
| | - Luiz E Nery
- Clinical Exercise Physiology Unit, Division of Pulmonology, Department o Medicine, Federal University of Sao Paulo, São Paulo, Brazil
| | - Denis E O'Donnell
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - J Alberto Neder
- Respiratory Investigation Unit, Division of Respirology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
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Olga M, Yuliya Z, Vitaly L, Ekaterina Z, Konstantin P, Svetlana E, Maria S, Tatyana V. Reference intervals and biological variation in parameters of the thrombin generation test in healthy individuals. Int J Lab Hematol 2024; 46:336-344. [PMID: 37985000 DOI: 10.1111/ijlh.14205] [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] [Received: 04/24/2023] [Accepted: 11/02/2023] [Indexed: 11/22/2023]
Abstract
INTRODUCTION Establish the referenceintervals (RIs) and analyze biological variability (BV) to introduce the thrombin generation test (TGT) into clinical practice. METHODS To determine the RIs parameters of TGT, we analyzed platelet-poor plasma (PPP) (n = 123), rich (PRP) (n = 76), and microparticle-mediated TGT (MP-TGT) (n = 32) in healthy participants. For the BV study, we collected samples from five participants over 5 weeks. A nested analysis of variance (ANOVA) was performed to evaluate the BV results. RESULTS The between-individual variation (CVG ), within-individual variation (CVI ), analytical variation (CVA ) for TGT on PPP for all parameters were from 5.5% to 17.3%, 5.4% to 17.7%, and 2.6% to 5.3%, respectively. For PRP, the CVG , CVI , and CVA were ranged from 3.0% to 23.7%, 8.4% to 23.0%, and 4.1% to 6.9%, respectively. The index of individuality (II) ranged from 0.3 to 3.1 for PPP and from 0.3 to 4.5 for PRP. The reference change value (RCV) for PPP was from 19.8% to 50.1%, while for PRP, it was 27.2% to 66.5%. We recommend using the RIs for the parameters ETP (nM/min): 1101.6-2332.1 and Peak (nM): 163.5-381.3 for PPP and ETP (nM/min): 1088.5-2634.9; Peak (nM): 72.6-210.7 for PRP. The resulting MP-TGT are highly dependent on age require a larger sample. CONCLUSION For TGT on PPP and PRP the RIs developed on our population for Peak and ETP parameters can be used. Time parameters: Lagtime and ttPeak, min with II < 0.6, require monitoring over time with RCV calculation.
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Affiliation(s)
- Melnichnikova Olga
- Personalized Medicine Centre, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - Zhilenkova Yuliya
- Department of Laboratory Medicine and Genetics, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - Lukinov Vitaly
- Personalized Medicine Centre, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - Zolotova Ekaterina
- Personalized Medicine Centre, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - Pishchulov Konstantin
- Personalized Medicine Centre, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - Evgina Svetlana
- Department of Laboratory Medicine and Genetics, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - Simakova Maria
- Personalized Medicine Centre, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
| | - Vavilova Tatyana
- Department of Laboratory Medicine and Genetics, Almazov National Medical Research Centre, Saint Petersburg, Russian Federation
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Nourizadeh M, Sarrafzadeh SA, Shoormasti RS, Fazlollahi MR, Saghafi S, Badalzadeh M, Mirmoghtadaei M, Pourpak Z. Determining reference ranges for lymphocyte proliferation responses to phytohemagglutinin and Bacillus Calmette-Guérin in Iranian children. Clin Immunol 2024; 261:109937. [PMID: 38346463 DOI: 10.1016/j.clim.2024.109937] [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: 02/08/2022] [Revised: 01/28/2024] [Accepted: 02/09/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE To establish reference ranges (RRs) for stimulation index of T cell proliferation triggered by phytohemagglutinin (PHA-SI) and Bacillus Calmette-Guérin (BCG-SI). METHODS This study investigated data from 359 healthy children and 35 patients with cellular immunodeficiency as positive controls (2010-2021). We applied a colorimetric-based method (BrdU) to measure proliferation and determine the RRs at the 2.5th and 97.5th percentiles (95% confidence intervals). A cross-validation approach was performed. RESULTS In healthy controls, the RRs for PHA-SI and BCG-SI ranged between 3 and 5.2 and 2.52 to 5.2, respectively. PHA-SI and BCG-SI were in Severe Combined Immunodeficiency (SCID) patients from 1.2 to 2.5 and 0 to 2, while in Mendelian susceptibility to mycobacterial diseases (MSMD) patients, 2.53 to 4.5 and 0.74 to 2.2, respectively. The thresholds' accuracy was checked for testing reference intervals with diagnostic effects. CONCLUSION This study establishes PHA-SI and BCG-SI reference ranges to aid in diagnosing and treating congenital immunodeficiency diseases.
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Affiliation(s)
- Maryam Nourizadeh
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Shokouh Azam Sarrafzadeh
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Raheleh Shokouhi Shoormasti
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Fazlollahi
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Shiva Saghafi
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Badalzadeh
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Milad Mirmoghtadaei
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Pourpak
- Immunology, Asthma and Allergy Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Children's Medical Center, Pediatrics Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.
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Pérez-Enríquez C, García-Escobar G, Florido-Santiago M, Piqué-Candini J, Arrondo-Elizarán C, Grau-Guinea L, Pereira-Cuitiño B, Manero RM, Puig-Pijoan A, Peña-Casanova J, Sánchez-Benavides G. Spanish normative studies (NEURONORMA-Plus project): norms for the Wisconsin Card Sorting Test, the Modified Taylor Complex Figure, and the Ruff-Light Trail Learning Test. Neurologia 2024; 39:235-243. [PMID: 37442426 DOI: 10.1016/j.nrleng.2021.05.014] [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: 03/11/2021] [Accepted: 05/12/2021] [Indexed: 07/15/2023] Open
Abstract
OBJECTIVE The present study aims to provide norms and age-, education-, and sex-adjusted data for the Wisconsin Card Sorting Test (WCST), the Modified Taylor Complex Figure (MTCF), and the Ruff-Light Trail Learning Test (RULIT) as part of the NEURONORMA-Plus project. METHODS We recruited 308 cognitively healthy individuals aged between 18 and 92 years. Tables are provided to convert raw scores to age-adjusted scaled scores, as well as adjustments for education and sex after applying independent regression models in 2 age groups (< 50 and ≥ 50 years). RESULTS Older age had a negative effect on performance in both age groups. We observed a positive effect of education on WCST performance in the younger group (< 50 years), and on all MTCF measures (with the exception of the recognition task) in the older group (≥ 50 years). Education had no impact on performance in the RULIT, although sex did, with a small but significant effect whereby young men showed higher performance for one variable. CONCLUSION The normative data provided can contribute to the clinical interpretation of performance in these tests in the Spanish population.
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Affiliation(s)
- C Pérez-Enríquez
- Grupo de neurofuncionalidad y lenguaje, Programa de neurociencias, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain; Unidad de Epilepsia, Servicio de Neurología, Hospital del Mar, Barcelona, Spain
| | - G García-Escobar
- Grupo de neurofuncionalidad y lenguaje, Programa de neurociencias, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain; Unidad de deterioro cognitivo y trastornos del movimiento, Servicio de Neurología, Hospital del Mar, Barcelona, Spain
| | - M Florido-Santiago
- Grupo de neurofuncionalidad y lenguaje, Programa de neurociencias, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain; Unidad de Salud Cerebral, Centro de Investigaciones Médico Sanitarias (CIMES), Málaga, Spain
| | - J Piqué-Candini
- Grupo de neurofuncionalidad y lenguaje, Programa de neurociencias, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain
| | - C Arrondo-Elizarán
- Grupo de neurofuncionalidad y lenguaje, Programa de neurociencias, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain; Servicio de Neurología, Clínica Universidad de Navarra, Pamplona, Spain
| | - L Grau-Guinea
- Grupo de neurofuncionalidad y lenguaje, Programa de neurociencias, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain
| | - B Pereira-Cuitiño
- Grupo de neurofuncionalidad y lenguaje, Programa de neurociencias, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain
| | - R M Manero
- Grupo de neurofuncionalidad y lenguaje, Programa de neurociencias, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain; Unidad de deterioro cognitivo y trastornos del movimiento, Servicio de Neurología, Hospital del Mar, Barcelona, Spain
| | - A Puig-Pijoan
- Grupo de neurofuncionalidad y lenguaje, Programa de neurociencias, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain; Unidad de deterioro cognitivo y trastornos del movimiento, Servicio de Neurología, Hospital del Mar, Barcelona, Spain
| | - J Peña-Casanova
- Grupo de neurofuncionalidad y lenguaje, Programa de neurociencias, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain.
| | - G Sánchez-Benavides
- Grupo de neurofuncionalidad y lenguaje, Programa de neurociencias, Instituto Hospital del Mar de Investigaciones Médicas (IMIM), Barcelona, Spain; Barcelonabeta Brain Research Center, Barcelona, Spain.
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Wolfsberger CH, Avian A, Schwaberger B, Pichler G, Wolf M, Urlesberger B. Precision and normal values of cerebral blood volume in preterm neonates using time-resolved near-infrared spectroscopy. Acta Paediatr 2024; 113:677-683. [PMID: 37970733 DOI: 10.1111/apa.17040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 08/21/2023] [Revised: 11/05/2023] [Accepted: 11/07/2023] [Indexed: 11/17/2023]
Abstract
AIM To investigate cerebral blood volume (CBV) in preterm neonates using time-resolved near-infrared spectroscopy. METHODS In this prospective observational study, time-resolved near-infrared spectroscopy measurements of CBV using tNIRS-1 were performed in 70 preterm neonates. For measurements, a sensor was placed for a duration of 1 min, followed by four further reapplications of the sensor, overall five measurements. RESULTS In this study, 70 preterm neonates with a mean ± SD gestational age of 33.4 ± 1.7 weeks and a birthweight of 1931 ± 398 g were included with a postnatal age of 4.7 ± 2.0 days. Altogether, 2383 CBV values were obtained with an overall mean of 1.85 ± 0.30 mL/100 g brain. A total of 95% of the measured CBV values varied in a range from -0.31 to 0.33 from the overall individual mean. Taking the deviation of the mean of each single application for each patient, this range reduced from -0.07 to 0.07. The precision of the measurement defined as within-variation in CBV was 0.24 mL/100 g brain. CONCLUSION The overall mean CBV in stable preterm neonates was 1.85 ± 0.30 mL/100 g brain. The within-variation in CBV was 0.24 mL/100 g brain. Based on the precision obtained by our data, CBV of 1.85 ± 0.30 mL/100 g brain may be assumed as normal value for this cohort.
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Affiliation(s)
- Christina Helene Wolfsberger
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
- Research Unit for Neonatal Macro- and Microcirculation, Medical University of Graz, Graz, Austria
- Research Unit for Cerebral Development and Oximetry Research, Medical University of Graz, Graz, Austria
| | - Alexander Avian
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria
| | - Bernhard Schwaberger
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
- Research Unit for Neonatal Macro- and Microcirculation, Medical University of Graz, Graz, Austria
- Research Unit for Cerebral Development and Oximetry Research, Medical University of Graz, Graz, Austria
| | - Gerhard Pichler
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
- Research Unit for Neonatal Macro- and Microcirculation, Medical University of Graz, Graz, Austria
- Research Unit for Cerebral Development and Oximetry Research, Medical University of Graz, Graz, Austria
| | - Martin Wolf
- Biomedical Optics Research Laboratory, Department of Neonatology, University of Zurich, University Hospital Zurich, Zurich, Switzerland
| | - Berndt Urlesberger
- Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
- Research Unit for Neonatal Macro- and Microcirculation, Medical University of Graz, Graz, Austria
- Research Unit for Cerebral Development and Oximetry Research, Medical University of Graz, Graz, Austria
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Gallelli MF, Zampini E, Trasorras V, Carretero MI, Bertuzzi M, Amusquibar V, Pereira M, Bianchi CP. Haematology and biochemistry in healthy llamas at sea level. Vet Res Commun 2024; 48:1253-1256. [PMID: 38105361 DOI: 10.1007/s11259-023-10285-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 12/14/2023] [Indexed: 12/19/2023]
Abstract
In the last years, there has been an increasing interest in llamas, not only as part of a productive system, but mostly as companion animals. Most reports regarding clinical biochemistry and haematology include few llamas and details about their health status are not available. The present study aims to provide haematological and biochemical parameters for llamas of known health status. Twenty-three non-pregnant females and seven males that live in Buenos Aires, Argentina (34°36'S, 58°22'W, at sea level) were studied. Llamas were clinically healthy, in good nutritional status. Animals were kept at grass and were fed hay bale or pellets and water ad libitum. Blood samples were collected by jugular venipuncture in spring. Packed cell volume, leucocyte count, differential white cell count, platelets count, urea, creatinine, total proteins, albumin, alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, glucose, calcium and phosphate were assessed. No significant differences were observed between males and females, except for platelet count and calcium, which was greater in males (P˂0.01). Values obtained for the different parameters were similar to those previously reported, except for monocytes, alkaline phosphatase, glucose and calcium, that were lower and lymphocytes and platelets count, that were higher in this study. In conclusion, different ambient and methodological conditions might affect some parameters. The parameters hereby presented are representative of llama's population living at sea level in South America.
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Affiliation(s)
- M F Gallelli
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina.
- Instituto de Investigación y Tecnología en Reproducción Animal (INITRA), Facultad de Ciencias Veterinarias, UBA, Buenos Aires, Argentina.
| | - E Zampini
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
- Instituto de Investigación y Tecnología en Reproducción Animal (INITRA), Facultad de Ciencias Veterinarias, UBA, Buenos Aires, Argentina
| | - V Trasorras
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
- Instituto de Investigación y Tecnología en Reproducción Animal (INITRA), Facultad de Ciencias Veterinarias, UBA, Buenos Aires, Argentina
| | - M I Carretero
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
- Instituto de Investigación y Tecnología en Reproducción Animal (INITRA), Facultad de Ciencias Veterinarias, UBA, Buenos Aires, Argentina
| | - M Bertuzzi
- Consejo Nacional de Investigaciones Científicas y Técnicas, Buenos Aires, Argentina
- Instituto de Investigación y Tecnología en Reproducción Animal (INITRA), Facultad de Ciencias Veterinarias, UBA, Buenos Aires, Argentina
| | - V Amusquibar
- Instituto de Investigación y Tecnología en Reproducción Animal (INITRA), Facultad de Ciencias Veterinarias, UBA, Buenos Aires, Argentina
| | - M Pereira
- Laboratorio de Análisis Clínicos, Hospital Escuela, Facultad de Ciencias Veterinarias, UBA, Buenos Aires, Argentina
| | - C P Bianchi
- Laboratorio de Endocrinología, CIVETAN, Fac. de Cs. Veterinarias, UNCPBA, Ciudad de Tandil, Buenos Aires, Argentina
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Revollo GB, Dipierri JE, Díaz MDP, Alfaro Gómez EL. Birth weight in the Northwest region of Argentina. Comparison with a national reference and an international standard. ARCH ARGENT PEDIATR 2024; 122:e202310051. [PMID: 37801682 DOI: 10.5546/aap.2023-10051.eng] [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] [Indexed: 10/08/2023]
Abstract
Introduction. Size at birth is subject to genetic and environmental influences; altitude is highly influential. Birth weight (BW) is the most widely used indicator to assess size at birth; different standards and references are available. Due to the variability in BW distribution in relation to altitude in the province of Jujuy (Argentina), the purpose of this study is to analyze the percentile distribution of BW in the highlands (HL) and the lowlands (LL) of Jujuy based on gestational age (GA) and sex and compare it with a national reference and the INTERGROWTH-21st (IG-21) international standard. Population and methods. The records of 78 524 live births in Jujuy in the 2009-2014 period were analyzed. Using the LMS method, the 3rd, 10th, 50th, 90th, and 97th percentiles of BW/GA by sex were estimated for the HL (≥ 2000 MASL), the LL (< 2000 MASL), and the total for Jujuy, and compared with the Argentine population reference by Urquía and the IG-21 standard using growth charts. The statistical significance was established using the Wilcoxon test. Results. BW in Jujuy showed a heterogeneous distribution, with statistically significant differences (p < 0.05) between the LL and the HL. When compared with the national reference and the IG-21 standard, differences in terms of altitude were observed, mainly in the 90th and 97th percentiles for both regions and the 3rd and 10th percentiles in the HL compared with the international standard. Conclusions. BW distribution varied in association with altitude; therefore, to assess intrauterine growth, it is critical to include GA and the environment in which the pregnancy takes place.
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Affiliation(s)
- Gabriela B Revollo
- Institute of Ecoregions of the Andes (Instituto de Ecorregiones Andinas, INECOA), National Scientific and Technical Research Council (Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET), Jujuy, Argentina
| | - José E Dipierri
- Institute of Ecoregions of the Andes (Instituto de Ecorregiones Andinas, INECOA), National Scientific and Technical Research Council (Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET), Jujuy, Argentina
| | - María Del Pilar Díaz
- Institute for Research in Health Sciences (Instituto de Investigaciones en Ciencias de la Salud, INICSA), School of Medical Sciences, Universidad Nacional de Córdoba, National Scientific and Technical Research Council (Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET), Córdoba, Argentina
| | - Emma L Alfaro Gómez
- Institute of Ecoregions of the Andes (Instituto de Ecorregiones Andinas, INECOA), National Scientific and Technical Research Council (Consejo Nacional de Investigaciones Científicas y Técnicas, CONICET), Jujuy, Argentina
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Madsen AT, Kristiansen HP, Winther-Larsen A. Short-term biological variation of serum tryptase. Clin Chem Lab Med 2024; 62:713-719. [PMID: 37882699 DOI: 10.1515/cclm-2023-0606] [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: 06/09/2023] [Accepted: 10/17/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVES Serum tryptase is a biomarker of mast cell activation. Among others, it is used in the diagnosis of anaphylaxis where a significant increase during the acute phase supports the diagnosis. When evaluating changes in biomarker levels, it is of utmost importance to consider the biological variation of the marker. Therefore, the aim of this study was to evaluate the short-term biological variation of serum tryptase. METHODS Blood samples were drawn at 9 AM three days in a row from apparently healthy subjects. On day two, additional blood samples were drawn every third hour for 12 h. The tryptase concentration was measured in serum using a fluoroenzyme immunoassay (ImmunoCAP™, Thermo Fisher Scientific). Linear mixed-effects models were used to calculate components of biological variation. RESULTS In 32 subjects, the overall mean concentration of tryptase was 4.0 ng/mL (range, 1.3-8.0 ng/mL). The within-subject variation was 3.7 % (95 % confidence interval (CI) 3.0-4.4 %), the between-subject variation was 31.5 % (95 % CI 23.1-39.8 %), and the analytical variation was 3.4 % (95 % CI 2.9-4.1 %). The reference change value was 13.3 % for an increase in tryptase at a 95 % level of significance. No significant day-to-day variation was observed (p=0.77), while a minute decrease in the serum concentration was observed during the day (p<0.0001). CONCLUSIONS Serum tryptase is a tightly regulated biomarker with very low within-subject variation, no significant day-to-day variation, and only minor semidiurnal variation. In contrast, a considerable between-subject variation exists. This establishes serum tryptase as a well-suited biomarker for monitoring.
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Affiliation(s)
- Anne Tranberg Madsen
- Department of Microbiology and Immunology, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Anne Winther-Larsen
- Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus N, Denmark
- Department of Clinical Medicine, Health, Aarhus University, Aarhus, Denmark
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Borai A, Ichihara K, Bahijri S, Alsofyani A, Elsayid M, Husain H, Boraie S, Sannan N, Kalantan Z, Jan M, Gassas M, Harbi M, Alrowaili N, Almohammadi M, Zarif H, Qurashi M. Establishment of reference interval for hemoglobin A1C and other hemoglobin subfractions for healthy Saudi adults. PLoS One 2024; 19:e0300028. [PMID: 38527010 PMCID: PMC10962850 DOI: 10.1371/journal.pone.0300028] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/20/2024] [Indexed: 03/27/2024] Open
Abstract
BACKGROUND The establishment of Reference Intervals (RIs) for Hemoglobin A1C and other hemoglobin subfractions (A1A, A1B, F, LA1C, A0) is of utmost importance in screening, diagnosing, and monitoring diabetes and other hemoglobin abnormalities through the application of high-pressure liquid chromatography (HPLC) technique. Because there are no locally established RIs for these parameters, it is essential to establish RIs specific to the Saudi population to accurately diagnose and monitor diabetic individuals and identify abnormal levels in hemoglobin subfractions. METHODS As part of the IFCC global multicenter study of laboratory reference values, a cross-sectional study was conducted in Saudi Arabia. The study involved recruiting a total of 381 healthy adult subjects (>18 years, BMI 28.3 ± 6 kg/m2). Blood samples were analyzed for A1C, biochemical and other immunoassay parameters. The need for RIs based on sex, age, and BMI was determined using the standard deviation ratio (SDR) through a 3-level nested ANOVA. RESULTS Based on the threshold of SDR≥0.4, RIs for A1C and other Hb subfractions were not partitioned by sex or BMI, but partitioned by age (<45 & ≥45 years) for A1C, LA1C, A0 and F. Spearman's correlation between glucose, insulin, and C-peptide showed a positive association with different hemoglobin subtractions of A1B, F, A1C, and LA1C. The RIs were obtained by using the parametric method and the latent abnormal values exclusion (LAVE) principle was applied on A1C. CONCLUSION This study established RIs for A1C and other Hb subfractions for healthy adult Saudis. Age was found to be an important source of variation for most of the parameters including A1C. These findings will enhance the understanding and clinical decision-making concerning A1C and other hemoglobin subfractions. The elevated upper limit of RIs for A1C reflects the high prevalence of diabetes in the Saudi population specially in those with increased age.
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Affiliation(s)
- Anwar Borai
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
| | - Kiyoshi Ichihara
- Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Suhad Bahijri
- Department of Clinical Biochemistry–Faculty of Medicine- King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abeer Alsofyani
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
| | - Mohieldin Elsayid
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
| | - Haitham Husain
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
| | - Sultanah Boraie
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
| | - Naif Sannan
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
| | - Ziad Kalantan
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
| | - Majdi Jan
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
| | - Maha Gassas
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
| | - Mohammed Harbi
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
| | | | - Mohammed Almohammadi
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
| | - Hawazen Zarif
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
| | - Mansour Qurashi
- King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Saudi Arabia
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Dülgeroğlu Y, Ercan M. Biological variation of serum neopterin concentrations in apparently healthy individuals. Clin Chem Lab Med 2024; 62:706-712. [PMID: 37882748 DOI: 10.1515/cclm-2023-1030] [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: 12/23/2022] [Accepted: 10/17/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVES The aims of this study were to determine the biological variation (BV), reference change value (RCV), index of individuality (II), and quality specifications for serum neopterin concentrations; a measurand provided by clinical laboratories as an indicator of cellular immunity. METHODS The study delivered serum samples collected for 10 consecutive weeks from 12 apparently healthy individuals (3 male, 9 female). Serum neopterin concentrations were measured using high-performance liquid chromatography with fluorometric detection. The data analysis was performed using an online statistical tool and addressed published criteria for estimation of biological variation. RESULTS The mean neopterin concentration was 5.26 nmol/L. The within-subject biological variation (CVI) with 95 % confidence interval (CI) of neopterin serum concentrations was 11.54 % (9.98-13.59), and the between-subject biological variation (CVG) with 95 % CI was 43.27 % (30.52-73.67). The neopterin asymmetrical RCV was -24.9 %/+33.1 %, and the II was 0.27. The desirable quality specifications for neopterin were <5.77 % for precision, <11.20 % for bias, and <20.72 % for total allowable error (TEa). When analytical variation was used instead of CVI to calculate TEa, the desirable TEa was <18.39. CONCLUSIONS This study determined BV data for neopterin, an indicator of cell-mediated immune response. Asymmetric RCV values, of 24.9 % decrease or a 33.1 % increase between consecutive measurements indicate significant change. The II of 0.27 indicates a high degree of individuality, therefore that it is appropriate to consider the use of personal reference data and significance of change rather than the reference interval as points of reference for the evaluation of neopterin serum concentrations.
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Affiliation(s)
- Yakup Dülgeroğlu
- Department of Medical Biochemistry, Yenisehir State Hospital, Bursa, Turkiye
| | - Müjgan Ercan
- Department of Medical Biochemistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkiye
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Kito S, Suda Y, Tanabe S, Takizawa T, Nagahata T, Tohyama N, Okamoto H, Kodama T, Fujita Y, Miyashita H, Shinoda K, Kurooka M, Shimizu H, Ohno T, Sakamoto M. Radiological imaging protection: a study on imaging dose used while planning computed tomography for external radiotherapy in Japan. J Radiat Res 2024; 65:159-167. [PMID: 38151953 PMCID: PMC10959444 DOI: 10.1093/jrr/rrad098] [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] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/10/2023] [Indexed: 12/29/2023]
Abstract
Previous studies have primarily focused on quality of imaging in radiotherapy planning computed tomography (RTCT), with few investigations on imaging doses. To our knowledge, this is the first study aimed to investigate the imaging dose in RTCT to determine baseline data for establishing national diagnostic reference levels (DRLs) in Japanese institutions. A survey questionnaire was sent to domestic RT institutions between 10 October and 16 December 2021. The questionnaire items were volume computed tomography dose index (CTDIvol), dose-length product (DLP), and acquisition parameters, including use of auto exposure image control (AEC) or image-improving reconstruction option (IIRO) for brain stereotactic irradiation (brain STI), head and neck (HN) intensity-modulated radiotherapy (IMRT), lung stereotactic body radiotherapy (lung SBRT), breast-conserving radiotherapy (breast RT), and prostate IMRT protocols. Details on the use of motion-management techniques for lung SBRT were collected. Consequently, we collected 328 responses. The 75th percentiles of CTDIvol were 92, 33, 86, 23, and 32 mGy and those of DLP were 2805, 1301, 2416, 930, and 1158 mGy·cm for brain STI, HN IMRT, lung SBRT, breast RT, and prostate IMRT, respectively. CTDIvol and DLP values in institutions that used AEC or IIRO were lower than those without use for almost all sites. The 75th percentiles of DLP in each treatment technique for lung SBRT were 2541, 2034, 2336, and 2730 mGy·cm for free breathing, breath holding, gating technique, and real-time tumor tracking technique, respectively. Our data will help in establishing DRLs for RTCT protocols, thus reducing imaging doses in Japan.
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Affiliation(s)
- Satoshi Kito
- Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan
- Department of Radiology, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo 130-8575, Japan
| | - Yuhi Suda
- Division of Radiation Oncology, Department of Radiology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, 3-18-22 Honkomagome, Bunkyo-ku, Tokyo 113-8677, Japan
- Department of Radiology, Tokyo Metropolitan Bokutoh Hospital, 4-23-15 Kotobashi, Sumida-ku, Tokyo 130-8575, Japan
| | - Satoshi Tanabe
- Department of Radiation Oncology, Niigata University Medical and Dental Hospital, 1-757 Asahimachi-dori, Chuo-ku, Niigata 951-8510, Japan
| | - Takeshi Takizawa
- Department of Radiation Oncology, Niigata Neurosurgical Hospital, 3057 Yamada, Nishi-ku, Niigata 950-1101, Japan
| | - Tomomasa Nagahata
- Radiological Division, Osaka Metropolitan University Hospital, 1-5-7 Asahi-chou, Osaka City, Osaka 545-8586, Japan
| | - Naoki Tohyama
- Division of Medical Physics, Tokyo Bay Makuhari Clinic for Advanced Imaging, Cancer Screening, and High-Precision Radiotherapy, 1-17 Toyosuna, Mihama-ku, Chiba 261-0024, Japan
| | - Hiroyuki Okamoto
- Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Takumi Kodama
- Department of Radiation Oncology, Saitama Cancer Center, 780, Ooazakomuro, Ina, Saitama 362-0806, Japan
| | - Yukio Fujita
- Department of Radiation Sciences, Komazawa University, 1-23-1 Komazawa, Setagaya, Tokyo 154-8525, Japan
| | - Hisayuki Miyashita
- Department of Radiation Oncology, St. Marianna University Hospital, 2-16-1, Sugao, Miyamae-ku, Kawasaki City, Kanagawa 216-8511, Japan
| | - Kazuya Shinoda
- Department of Radiation Therapy, Ibaraki Prefectural Central Hospital, 6528 Koibuchi, Kasama City, Ibaraki 309-1793, Japan
| | - Masahiko Kurooka
- Department of Radiation Therapy, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan
| | - Hidetoshi Shimizu
- Department of Radiation Oncology, Aichi Cancer Center Hospital, 1-1, Kanokoden, Chikusa-ku, Aichi 464-8684, Japan
| | - Takeshi Ohno
- Department of Health Sciences, Faculty of Life Sciences, Kumamoto University, 4-24-1 Kuhonji, Chuo-ku, Kumamoto 862-0976, Japan
| | - Masataka Sakamoto
- Department of Radiology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka 431-3192, Japan
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Huo B, Chen X, Xu Z, He D, Wang J. Exposure frequency and radiation dose from CT examinations in Huaian. Radiat Prot Dosimetry 2024; 200:396-402. [PMID: 38195745 DOI: 10.1093/rpd/ncad302] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 11/12/2023] [Accepted: 11/22/2023] [Indexed: 01/11/2024]
Abstract
This study quantified the exposure frequency and established the local diagnostic reference levels (DRLs) for the most common computed tomography (CT) examinations. A combined method census and sampling survey was used to quantify both frequency and radiation dose of CT examinations. Data were acquired through Picture Archiving and Communication System (PACS) or Radiology Information System (RIS). The annual frequency of CT examinations was 239.8 per 1000 inhabitants. The P75 of volume CT dose index (CTDIvol) to adult patients from CT scanning for head, chest, abdomen and lumbar spine examinations were 63.0, 12.4, 20.0 and 24.0 mGy, respectively. The P75 of dose-length product were 858.6, 416.0, 620.7 and 559.2 mGy·cm, respectively. This dose audit of CT practice can act as a starting point for establishing Huaian local DRLs and could be a reference for dose optimisation in China. This study compared DRLs in different countries and analysed some reasons for the rapid growth of CT examination frequency in Huaian.
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Affiliation(s)
- Binbin Huo
- Occupational Health Division, Huaian Center for Disease Control and Prevention, Huaian, Jiangsu 223002, China
| | - Xiaomin Chen
- Occupational Health Division, Huaian Center for Disease Control and Prevention, Huaian, Jiangsu 223002, China
| | - Zhiyong Xu
- Occupational Health Division, Huaian Center for Disease Control and Prevention, Huaian, Jiangsu 223002, China
| | - Dongdong He
- Occupational Health Division, Huaian Center for Disease Control and Prevention, Huaian, Jiangsu 223002, China
| | - Jin Wang
- Radiation Protection Institute, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu 221005, China
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Chen JF, Wu ZQ, Liu HS, Yan S, Wang YX, Xing M, Song XQ, Ding SY. Cumulative effects of excess high-normal alanine aminotransferase levels in relation to new-onset metabolic dysfunction-associated fatty liver disease in China. World J Gastroenterol 2024; 30:1346-1357. [PMID: 38596503 PMCID: PMC11000085 DOI: 10.3748/wjg.v30.i10.1346] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/12/2024] [Accepted: 02/18/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Within the normal range, elevated alanine aminotransferase (ALT) levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease (MAFLD). AIM To investigate the associations between repeated high-normal ALT measurements and the risk of new-onset MAFLD prospectively. METHODS A cohort of 3553 participants followed for four consecutive health examinations over 4 years was selected. The incidence rate, cumulative times, and equally and unequally weighted cumulative effects of excess high-normal ALT levels (ehALT) were measured. Cox proportional hazards regression was used to analyse the association between the cumulative effects of ehALT and the risk of new-onset MAFLD. RESULTS A total of 83.13% of participants with MAFLD had normal ALT levels. The incidence rate of MAFLD showed a linear increasing trend in the cumulative ehALT group. Compared with those in the low-normal ALT group, the multivariate adjusted hazard ratios of the equally and unequally weighted cumulative effects of ehALT were 1.651 [95% confidence interval (CI): 1.199-2.273] and 1.535 (95%CI: 1.119-2.106) in the third quartile and 1.616 (95%CI: 1.162-2.246) and 1.580 (95%CI: 1.155-2.162) in the fourth quartile, respectively. CONCLUSION Most participants with MAFLD had normal ALT levels. Long-term high-normal ALT levels were associated with a cumulative increased risk of new-onset MAFLD.
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Affiliation(s)
- Jing-Feng Chen
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Zhuo-Qing Wu
- Institute of Systems Engineering, Dalian University of Technology, Dalian 116024, Liaoning Province, China
| | - Hao-Shuang Liu
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Su Yan
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - You-Xiang Wang
- College of Public Health, Zhengzhou University, Zhengzhou 450001, Henan Province, China
| | - Miao Xing
- School of Basic Medicine and Forensic Medicine, Henan University of Science and Technology, Luoyang 471003, Henan Province, China
| | - Xiao-Qin Song
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Su-Ying Ding
- Health Management Center, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
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50
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Xu C, Fan K, Mo W, Cao X, Jiao K. Dual ensemble system for polyp segmentation with submodels adaptive selection ensemble. Sci Rep 2024; 14:6152. [PMID: 38485963 PMCID: PMC10940608 DOI: 10.1038/s41598-024-56264-2] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
Colonoscopy is one of the main methods to detect colon polyps, and its detection is widely used to prevent and diagnose colon cancer. With the rapid development of computer vision, deep learning-based semantic segmentation methods for colon polyps have been widely researched. However, the accuracy and stability of some methods in colon polyp segmentation tasks show potential for further improvement. In addition, the issue of selecting appropriate sub-models in ensemble learning for the colon polyp segmentation task still needs to be explored. In order to solve the above problems, we first implement the utilization of multi-complementary high-level semantic features through the Multi-Head Control Ensemble. Then, to solve the sub-model selection problem in training, we propose SDBH-PSO Ensemble for sub-model selection and optimization of ensemble weights for different datasets. The experiments were conducted on the public datasets CVC-ClinicDB, Kvasir, CVC-ColonDB, ETIS-LaribPolypDB and PolypGen. The results show that the DET-Former, constructed based on the Multi-Head Control Ensemble and the SDBH-PSO Ensemble, consistently provides improved accuracy across different datasets. Among them, the Multi-Head Control Ensemble demonstrated superior feature fusion capability in the experiments, and the SDBH-PSO Ensemble demonstrated excellent sub-model selection capability. The sub-model selection capabilities of the SDBH-PSO Ensemble will continue to have significant reference value and practical utility as deep learning networks evolve.
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Affiliation(s)
- Cun Xu
- Guilin University of Electronic Technology, Guilin, 541000, China
| | - Kefeng Fan
- China Electronics Standardization Institute, Beijing, 100007, China.
| | - Wei Mo
- Guilin University of Electronic Technology, Guilin, 541000, China
| | - Xuguang Cao
- Guilin University of Electronic Technology, Guilin, 541000, China
| | - Kaijie Jiao
- Guilin University of Electronic Technology, Guilin, 541000, China
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