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Artificial neural network and logistic regression modelling to characterize COVID-19 infected patients in local areas of Iran. Biomed J 2021; 44:304-316. [PMID: 34127421 PMCID: PMC7905378 DOI: 10.1016/j.bj.2021.02.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 02/11/2021] [Accepted: 02/17/2021] [Indexed: 01/08/2023] Open
Abstract
Background COVID-19 is an infectious disease that started spreading globally at the end of 2019. Due to differences in patient characteristics and symptoms in different regions, in this research, a comparative study was performed on COVID-19 patients in 6 provinces of Iran. Also, multilayer perceptron (MLP) neural network and Logistic Regression (LR) models were applied for the diagnosis of COVID-19. Methods A total of 1043 patients with suspected COVID-19 infection in Iran participated in this study. 29 characteristics, symptoms and underlying disease were obtained from hospitalized patients. Afterwards, we compared the obtained data between confirmed cases. Furthermore, the data was applied for building the ANN and LR models to diagnosis the infected patients by COVID-19. Results In 750 confirmed patients, Common symptoms were: fever (%) >37.5 °C, cough, shortness of breath, fatigue, chills and headache. The most common underlying diseases were: hypertension, diabetes, chronic obstructive pulmonary disease and coronary heart disease. Finally, the accuracy of the ANN model to the diagnosis of COVID-19 infection was higher than the LR model. Conclusion The prevalent symptoms and underlying diseases of COVID-19 patients were similar in different provinces, but the incidence of symptoms was significantly different from each other. Also, the study demonstrated that ANN and LR models have a high ability in the diagnosis of COVID-19 infection.
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Complications and costs of minimally invasive versus open radical hysterectomy for early stage cervical cancer. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.03.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Optimal Adjuvant Management for FIGO Stage III Endometrial Cancer: Is Timing Everything? Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Impact and Fracture Strength of Simulated Immature Teeth Treated with Mineral Trioxide Aggregate Apical Plug and Fiber Post Versus Revascularization. J Endod 2018; 44:1878-1882. [PMID: 30390973 DOI: 10.1016/j.joen.2018.09.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/08/2018] [Accepted: 09/11/2018] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Immature necrotic teeth are at a high risk of fracture, especially at the cervical region, after treatment. This study aimed to compare the impact and fracture strength of immature permanent teeth treated with revascularization versus a mineral trioxide aggregate (MTA) plug and fiber post. METHODS This in vitro, experimental study was conducted on 160 maxillary central incisors, which were randomly divided into 10 groups. The groups included a fracture (F) and impact (I) negative control group, F and I positive control groups, F and I MTA groups, F and I revascularizing group, and F and I revascularized groups. Fracture strength was measured using a universal testing machine with a crosshead speed of 1 mm/min. Other tooth samples were then subjected to the Charpy impact test for impact strength measurements, and the amount of energy absorbed by the teeth was determined. Data were analyzed using the Kolmogorov-Smirnov test, analysis of variance, and the Tukey test. RESULTS The mean load to fracture of the negative, positive, MTA, revacularizing, and revascularized groups was 1931.8, 1350.1, 1003.8, 1262.5, and 1100.2 N, respectively, and the mean impact strength was 5.04, 3.6, 3.68, 3.16, and 3.65 J, respectively. The fracture and impact strength of the negative control group was significantly higher than that of the other groups (P < .05), but the other groups were not significantly different in this respect (P > .05). CONCLUSIONS Despite the limitations of this study, the results showed that none of the tested modalities could significantly increase the impact and fracture strength of simulated immature teeth.
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Minimally invasive interval debulking surgery after neoadjuvant chemotherapy for ovarian cancer. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.03.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Benign surgery performed by gynecologic oncologists: Is selection bias altering our ability to measure surgical quality? Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Race and route of hysterectomy: Examining disparities in postoperative complications. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Survival disparities for black race persist despite treatment at high-volume centers for ovarian cancer. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Overall survival among American women with gestational trophoblastic neoplasia: A National Cancer Data Base study. Gynecol Oncol 2018. [DOI: 10.1016/j.ygyno.2018.04.442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Prognosis and survival of gynecologic leiomyosarcoma: A National Cancer Data Base study. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Vaginal brachytherapy and multi-agent chemotherapy increases survival of women with stage I carcinosarcoma. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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The influence of political party on gynecologic cancer research funding in the United States. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Determinants and Trends of Gynecologic Minimally Invasive Surgery in Developing Countries. J Minim Invasive Gynecol 2016; 22:S92-S93. [PMID: 27679380 DOI: 10.1016/j.jmig.2015.08.249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Sub-lethal doses of photodynamic therapy affect biofilm formation ability and metabolic activity of Enterococcus faecalis. Photodiagnosis Photodyn Ther 2016; 15:159-66. [PMID: 27328452 DOI: 10.1016/j.pdpdt.2016.06.003] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 06/05/2016] [Accepted: 06/13/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND During photodynamic therapy (PDT) in the treatment of a primary endodontic infection, it is extremely likely that microorganisms would be exposed to sub-lethal doses of PDT (sPDT). Although sPDT cannot kill microorganisms, it can considerably influence microbial virulence. This study was conducted to characterize the effect of sPDT using toluidine blue O (TBO), methylene blue (MB), and indocyanine green (ICG) on biofilm formation ability and metabolic activity of Enterococcus faecalis. METHODS The antimetabolic and antibiofilm potential of ICG-, TBO-, and MB-sPDT against E. faecalis was analyzed at sub-lethal doses (1/2-1/64 minimum inhibitory concentration) using the XTT reduction assay, crystal violet assay, and scanning electron microscopy. RESULTS Higher doses of sPDT adversely affected biofilm formation ability and metabolic activity. ICG-, TBO-, and MB-PDT at a maximum sub-lethal dose markedly reduced the formation of biofilm up to 42.8%, 22.6%, and 19.5%, respectively. ICG-, TBO-, and MB-sPDT showed a marked reduction in bacterial metabolic activity by 98%, 94%, and 82%, respectively. ICG-PDT showed a stronger inhibitory effect on biofilm formation in E. faecalis than MB- and TBO-PDT at sub-lethal levels. Interestingly, a gradual increase in metabolic activity and biofilm formation upon exposure to a lower dose of test sPDT were observed. CONCLUSION sPDT showed dual effect on biofilm formation ability and metabolic activity of E. faecalis. High doses revealed antimetabolic and antibiofilm potential activity, whereas lower doses had conflicting results. Hence, when PDT is prescribed in clinical settings, the dose of PDT used in vivo should be taken into consideration.
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High-grade serous ovarian cancer primary tumor BRCA1 mRNA expression is a candidate biomarker for patient selection for intraperitoneal chemotherapy. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Surgical wait time: A new health indicator in women with endometrial cancer. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Ovarian Cancer Early Detection and Prevention Program (OCEDPP): A specimen and data study. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.04.170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Evaluation of antimicrobial photodynamic therapy with indocyanine green and curcumin on human gingival fibroblast cells: An in vitro photocytotoxicity investigation. Photodiagnosis Photodyn Ther 2016; 15:13-8. [PMID: 27177809 DOI: 10.1016/j.pdpdt.2016.05.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 05/07/2016] [Accepted: 05/09/2016] [Indexed: 02/06/2023]
Abstract
UNLABELLED Recent investigations have suggested that antimicrobial photodynamic therapy (aPDT) can be an alternative treatment for the management of periodontal infections. However, currently there is very limited data regarding the photocytotoxicity of this method on human gingival fibroblast (HuGu) cells. AIM The in vitro optimal concentrations of indocyanine green (ICG) and curcumin as photosensitizers (PSs) and the irradiation time of diode laser emission were evaluated by assessing the photocytotoxicity of the treatment on HuGu cells. MATERIALS AND METHOD Monolayers of HuGu cells were incubated with various final concentrations of ICG (500, 750, 1000, 1250, 1500, 1750, and 2000μg/ml) and curcumin (3, 4, 5, 10, and 20mM). Three exposure times of the diode laser (30s, 60s, and 2×30s irradiation with an interval of 1min between each) and one of exposure time of 5min for LED were tested; cell viability was determined using neutral red assay. Chlorhexidine (CHX) as a gold standard antimicrobial agent for periodontal disease was considered as a control group. RESULTS ICG and curcumin significantly reduced HuGu cell viability at concentrations below 1000μg/ml and 10mM, respectively (P<0.01). Cytotoxicity was higher when the cells were treated for 2×30s irradiation with an interval of 1min and then again exposed to the laser for 30s (2% and 0.1%). CHX demonstrated no significant reduction in HuGu cell survival. CONCLUSION Photocytotoxicity is influenced by PS concentration, exposure time of PS, and time of irradiation. High doses of ICG and curcumin with lowest exposure time of light source and without cytotoxic effects may be an effective strategy for aPDT as an alternative treatment for periodontal disease.
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Frequency of Iatrogenic Errors through Root Canal Treatment Procedure in 1335 Charts of Dental Patients. J Int Oral Health 2015. [PMID: 26225098 PMCID: PMC4516079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Endodontic procedures such as root canal treatment would be at the risk of failure like other medical interventions due to any unsuitable conditions. This has a causative effect in making the procedure more complicated to resulting in weak prognosis finally. Technical errors such as ledge, perforation, obstruction, broken instrument, etc. make infection control too hard or impossible. The aims of this study are common errors frequency and types of root canal treatments focusing on defined groups of dental students in Qazvin, Iran. MATERIALS AND METHODS All the errors were divided into three major kinds of: (1) During providing access cavity, (2) cleaning and preparation and (3) canal obturation. RESULTS A total number of 1335 charts of the cases were studied in the field of root canal treatment. The whole number of charts, which reported errors was 880 (66%) while 455 (34%) error-free ones. The most frequent error in upper incisors was void with the rate of 50.9%, followed by overfilling (apical perforation) in 18.2%. The same errors were also most common for lower incisors in addition to imperfect cleaning. CONCLUSIONS The current study identified the least mistakes through the process of providing access cavity and instrumentation phase comparing obturation phase, which had the most frequent errors including void, overfilling and imperfect cleaning.
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The effect of low level laser therapy on pain reduction after third molar surgery. MINERVA STOMATOLOGICA 2012; 61:319-322. [PMID: 22976514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM The aim of this study was to evaluate the effects of low level laser on the postoperative pain of patients who had to undergo third molar surgery. METHODS In a randomized clinical setting, 100 patients were assigned to two groups of 50 in each. Every patient underwent surgical removal of one mandibular third molar (with osteotomy). After suturing the flap, the soft laser was applied to every patient. In group I laser radiation was applied by the dental assistant with output power of 100 mW, in continuous mode with sweeping motion, in group II, the laser hand piece was only brought into position without releasing energy, so that no patient knew which group he belonged to. The patient was given a pain evaluation form where they could determine their individual pain level and duration. RESULTS The statistical tests showed significant difference in pain level between laser and control group (P<0.001) but no significant difference found in pain duration in two groups (P=0.019). CONCLUSION The result of this study verifies the positive effect of the soft-laser therapy in the postoperative complication after third molar extraction.
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Class III β-tubulin (TUBB3): more than a biomarker in solid tumors? Curr Mol Med 2012; 11:726-31. [PMID: 21999149 DOI: 10.2174/156652411798062368] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2010] [Revised: 06/16/2011] [Accepted: 08/22/2011] [Indexed: 11/22/2022]
Abstract
Class III β-tubulin (TUBB3) is a prominent mechanism of drug resistance expressed in a variety of solid tumors and particularly in lung and ovarian cancer. In the classical view, TUBB3 expression and drug resistance have been linked, and together they have been associated with a perturbation in microtubule dynamics. In keeping with this observation, TUBB3 was associated with drug resistance only when chemotherapy included a taxane in its chemical composition. In this review, we demonstrate that the classical supposition about TUBB3 is not correct, and that instead TUBB3 expression is linked to drug resistance as a complex survival mechanism activated by microenvironmental conditions such as poor nutrient supply and hypoxia.
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SEM Evaluation of tooth surface irradiated by different parameters of Er:YAG laser. Med Oral Patol Oral Cir Bucal 2012. [DOI: 10.4317/medoral.17643686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Comparison of Microleakage of Glass Ionomer Restoration in Primary Teeth Prepared by Er: YAG Laser and the Conventional Method. JOURNAL OF DENTISTRY (TEHRAN, IRAN) 2012; 9:215-20. [PMID: 23119130 PMCID: PMC3484825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/07/2012] [Accepted: 07/04/2012] [Indexed: 11/21/2022]
Abstract
OBJECTIVE One of the main criteria in evaluating the restorative materials is the degree of microleakage. The aim of this study was to compare the microleakage of glass ionomer restored cavities prepared by Er:YAG laser or turbine and bur. MATERIALS AND METHODS Twenty extracted caries-free deciduous posterior teeth were selected for this study. The teeth were randomly divided into two groups for cavity preparation. Cavities in group one were prepared by high speed turbine and bur. In the second group, Er:YAG laser with a 3W output power, 300 mJ energy and 10 Hz frequency was used. Cavities were restored with GC Fuji II LC. After thermocycling, the samples were immersed into 0.5% methylene blue solution. They were sectioned for examination under optic microscope. RESULTS The Wilcoxon signed ranks test showed no significant difference between microleakage of the laser group and the conventional group (P>0.05). CONCLUSION Er:YAG laser with its advantages in pediatric dentistry may be suggested as an alternative device for cavity preparation.
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Histologic evaluation of inferior alveolar lymphatics: an anatomic study. ACTA ACUST UNITED AC 2011; 112:564-7. [DOI: 10.1016/j.tripleo.2010.11.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2010] [Revised: 11/02/2010] [Accepted: 11/12/2010] [Indexed: 11/29/2022]
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Effect of Ramadan fasting on serum heat shock protein 70 and serum lipid profile. Singapore Med J 2011; 52:491-495. [PMID: 21808959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Ramadan, the holy month for the Islamic world, is a period every year when food and fluid intake is restricted to the pre-sunrise and post-sunset hours. The aim of this study was to evaluate the effect of Ramadan fasting on the serum concentration of heat shock protein 70 (HSP70) and serum lipid profile in healthy men. METHODS A total of 32 male volunteers with a mean age of 28.5 (range 23-37) years were selected for the study. Blood samples were obtained one day prior to Ramadan and on the 3rd and 25th days of fasting. Serum HSP70, triglyceride (TG), cholesterol (Chol), low-density lipoprotein (LDL) and high-density lipoprotein (HDL), LDL/HDL and Chol/HDL ratios were investigated. RESULTS It was observed that the mean concentrations of serum HSP70 and HDL on the 25th day of Ramadan were significantly higher than those recorded one day before Ramadan and on the 3rd day of Ramadan, and the levels on the 3rd day of Ramadan was significantly higher than those recorded one day before Ramadan. Mean concentrations of serum TG, Chol, LDL, and LDL/HDL and Chol/HDL ratios on the 25th day of Ramadan were significantly lower than those recorded one day before Ramadan and on the 3rd day of Ramadan, and the levels found on the 3rd day of Ramadan were also significantly lower than those recorded one day before Ramadan. CONCLUSION Ramadan fasting increases serum HSP70 and improves serum lipid profile.
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The cytoskeletal gateway for tumor aggressiveness in ovarian cancer is driven by class III β-tubulin. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Gp96 rich lysate as a vaccine candidate against infection with Salmonella typhimurium. IRANIAN JOURNAL OF MICROBIOLOGY 2010; 2:172-7. [PMID: 22347568 PMCID: PMC3279793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND AND OBJECTIVES Glycoprotein 96 is the primary chaperone of the endoplasmic reticulum. Immunization with it induced potent Cytotoxic T lymphocyte responses to intracellular bacteria. S. typhimurium is a facultative intracellular bacterium and acquired resistance against this bacterium mainly depends on activity of Cytotoxic T cells. This study aimed to evaluate the capacity of Glycoprotein 96 rich lysate as a vaccine candidate to induce a protective immune response in mice against a lethal dose challenge with Salmonella typhimurium. MATERIALS AND METHODS Mice were infected with S. typhimurium. Then their spleens and livers were harvested and homogenized and the protein content of whole crude lysate was enriched using ammonium sulfate precipitation. SDS-polyacrylamide gel electrophoresis transfer method was used for enrichment of the protein from crude sample. Immunoblotting was conducted to detect Glycoprotein 96. Isoelectric point was achieved through the use of isoelectric focusing. PBS and whole crude lysate (from uninfected and infected mice) were injected to mice of test group, mice of control-1 group and mice of control-2 group, respectively, on days 0 and 14. Twenty-one days after the last immunization, the LD50 and bacterial loads of livers and spleens were determined. RESULTS AND CONCLUSION Immunization with Glycoprotein 96 rich lysate isolated from livers and spleens of S. typhimuriuminfected mice induced protection against infection by S. typhimurium. Also, the bacterial burden of livers and spleens in mice that received gp96 rich lysate significantly decreased when compared to that of mice in the control groups.
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Rising CA-125 levels within the normal range in patients with uterine papillary serous cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e15510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Immune response to measles vaccine after mass vaccination in Urmia, Islamic Republic of Iran. EASTERN MEDITERRANEAN HEALTH JOURNAL 2009. [DOI: 10.26719/2009.15.3.516] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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The relevance of rising CA-125 levels within the normal range in predicting recurrence in patients with advanced stage ovarian cancer: A validation study. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e16521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e16521 Background: Small published series suggested that three progressively rising CA-125 values, doubling of CA-125, and an absolute rise of 5 U/mL from the nadir, all while remaining in the normal range were highly associated with disease recurrence. This study aims to validate these proposed criteria in a larger population. Methods: We conducted a retrospective review of the records of patients with stages IIIC and IV epithelial ovarian cancer treated with primary surgery and adjuvant chemotherapy between 1994 and 2006. Only patients who had a complete response to chemotherapy verified by normal CT scan, CA-125 and physical examination were included. Nadir CA-125 level was defined as the first CA-125 measurement after completing chemotherapy. Available CA-125 values from diagnosis to recurrence or to last follow up were collected and evaluated for meeting any of the criteria above. Results: 91 patients with a median age of 59 (42 - 88) met the inclusion criteria. 82 patients had stage IIIC (90%) and 9 patients (10%) had stage IV. 86 patients (94.5%) had papillary serous histology and 88 patients had grade 3 (96.7%) disease. Median follow up was 43.7 months (12.6 - 156). Table 1 shows the number of patients who met any of the above CA-125 criteria in total and divided by the presence or absence of recurrence. There was no statistically significant difference in meeting any of the CA-125 criteria between the recurrence and no recurrence groups. Meeting at least one of the CA-125 criteria had 50% sensitivity, 65% specificity, and 86% positive predictive value for recurrence. The median time to recurrence in patients who met at least one CA-125 criteria was 3.8 months (0.2 - 12.4) and the median follow up time after meeting one of the CA 125 criteria in patients who did not recur was 88.5 months (10.4 - 188) Conclusions: Rising CA-125 levels within the normal range that meet any of the above criteria are highly predictive (86%) of recurrence within 12 months and closer observation is warranted. [Table: see text] No significant financial relationships to disclose.
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Immune response to measles vaccine after mass vaccination in Urmia, Islamic Republic of Iran. EASTERN MEDITERRANEAN HEALTH JOURNAL = LA REVUE DE SANTE DE LA MEDITERRANEE ORIENTALE = AL-MAJALLAH AL-SIHHIYAH LI-SHARQ AL-MUTAWASSIT 2009; 15:516-525. [PMID: 19731767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We investigated the effectiveness of the mass measles vaccination campaign in Urmia, Islamic Republic of Iran, by examining the measles IgG seroprevalence and antibody response from paired data before and after the campaign. The overall seropositive rate of 624 subjects aged 5-25 years increased 1 year after the mass vaccination (from 53.0% to 72.3%). A rise in antibody titre occurred in all age groups except the 21-25 years group, which had the highest titre before mass vaccination. On logistic regression analysis, only immune status prior to vaccination was significantly associated with the seroresponse. It may be cost-effective to check antibody titres before mass vaccinations, especially in high vaccine coverage regions with circulating wild virus.
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Microleakage of composite resin restorations in cervical cavities prepared by Er,Cr:YSGG laser radiation. Aust Dent J 2008; 53:172-5. [DOI: 10.1111/j.1834-7819.2008.00028.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Antibacterial Effects of Iranian Cuminum cyminum Essential Oil on Burn Isolates of Pseudomonas aeruginosa. INT J PHARMACOL 2008. [DOI: 10.3923/ijp.2008.157.159] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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The response of five primary ovarian cancer cell lines to taxol compared to the results of extreme drug resistance (EDR) assays. J Clin Oncol 2005. [DOI: 10.1200/jco.2005.23.16_suppl.9663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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The role of hyperglycosylated hCG in trophoblast invasion and the prediction of subsequent pre-eclampsia. Prenat Diagn 2002; 22:478-81. [PMID: 12116306 DOI: 10.1002/pd.329] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Hyperglycosylated hCG (HhCG) is the predominant form of chorionic gonadotrophin in states characterized by aggressive trophoblast invasion such as early pregnancy or choriocarcinoma. Pre-eclampsia may be the result of failed or inadequate trophoblast invasion. We investigated whether low levels of maternal urine HhCG levels would predict subsequent pre-eclampsia. STUDY DESIGN Mid-trimester urine (14-21 weeks) was collected and frozen from non-hypertensive women undergoing genetic amniocentesis. Inclusion criteria were: normal singleton pregnancies without a prior history of pre-eclampsia, hypertension, diabetes or other vascular disorders. The specimens were subsequently thawed, and HhCG levels standardized to urine creatinine were measured. Maternal charts were reviewed after delivery to determine the development of pre-eclampsia. There were a total of 568 study subjects. RESULTS Pre-eclampsia developed in 26 (4.6%) women. There was a significant correlation between low urine HhCG and subsequent pre-eclampsia (Mantel-Haenszel test of linear association: Chi-square 10.52, p=0.001). The mean HhCG level (ng/mg creatinine) was significantly greater in normals than in those destined to develop pre-eclampsia: 42.7 versus 20.3, p=0.002 (Mann-Whitney U-test). There was a progressive increase in the risk of subsequent pre-eclampsia as HhCG levels fell: HhCG < or =0.9 MoM RR (95% CI)=1.51 (1.15-1.98) compared with < or =0.1 MoM 10.42 (2.0-54.3). CONCLUSION Low maternal mid-trimester urine HhCG predicted subsequent pre-eclampsia. This appears to support the view that pre-eclampsia results at least in part from poor trophoblast invasion. Thus, HhCG may play a role in trophoblast invasion and measurement of this in urine identifies women at high risk for developing pre-eclampsia.
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Management of a ruptured basilar artery aneurysm during pregnancy. Acta Chir Belg 2001; 101:193-5. [PMID: 11680064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
A 36 year old woman who ruptured a basilar artery aneurysm at 38 weeks gestation in her second pregnancy was managed successfully by endovascular embolisation 36 hours after an emergency Caesarean section. The timing of treatment along with the obstetric, neurosurgical and anaesthetic aspects of this complex problem are discussed along with a review of the current literature on the subject.
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Utility of commonly used commercial human chorionic gonadotropin immunoassays in the diagnosis and management of trophoblastic diseases. Clin Chem 2001; 47:308-15. [PMID: 11159780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
BACKGROUND Patients with trophoblastic diseases produce ordinary and irregular forms of human chorionic gonadotropin (hCG; e.g., nicked hCG, hCG missing the beta-subunit C-terminal segment, hyperglycosylated hCG, and free beta subunit) that are recognized to differing extents by automated immunometric hCG (or hCG beta) assays. This has led to low or false-negative results and misdiagnosis of persistent disease. False-positive hCG immunoreactivity has also been detected, leading to needless therapy for trophoblastic diseases. Here we compare seven commonly used hCG assays. METHODS Standards for five irregular forms hCG produced in trophoblastic diseases, serum samples from 59 patients with confirmed trophoblastic diseases, and serum samples from 12 women with previous false-positive hCG results (primarily in the Abbott AxSYM assay) were blindly tested by commercial laboratories in the Beckman Access hCG beta, the Abbott AxSYM hCG beta, the Chiron ACS:180 hCG beta, the Baxter Stratus hCG test, the DPC Immulite hCG test, the Serono MAIAclone hCG beta tests, and in the hCG beta RIA. RESULTS Only the RIA and the DPC appropriately detected the five irregular hCG standards. Only the Beckman, DPC, and Abbott assays gave results similar to the RIA in the patients with confirmed trophoblastic diseases (values within 25% of RIA in 49, 49, and 54 of 59 patients, respectively). For samples that were previously found to produce false-positive hCG results, no false-positive results were detected with the DPC and Chiron tests (5 samples, median <2 IU/L), but up to one-third of samples were false positive (>10 IU/L) in the Beckman (1 of 5), Serono (2 of 9), and Baxter assays (1 of 5), and the hCG beta RIA (3 of 9; median for all assays, <5 IU/L). These samples, which produced false-positive results earlier in the Abbott AxSYM assay, continued to produce high values upon reassessment (median, 81 IU/L). CONCLUSIONS Of six frequently used hCG immunometric assays, only the DPC detected the five irregular forms of beta hCG, agreed with the RIA, and avoided false-positive results in the samples tested. This assay, and similarly designed assays not tested here, seem appropriate for hCG testing in the diagnosis and management of trophoblastic diseases.
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The role of laparoscopy in the diagnosis and treatment of peritoneal carcinomatosis: a case report. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2001; 74:107-10. [PMID: 11393262 PMCID: PMC2588690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A patient presented with deep venous thrombosis and an elevated CA-125 level, but normal pelvic ultrasound and abdominal and pelvic CT scans. Laparoscopy revealed diffuse carcinomatosis and a diagnosis of stage IIIc, poorly differentiated epithelial ovarian carcinoma was made. Laparoscopy may provide an alternative means of diagnosis when conventional imaging fails, and may facilitate the placement of catheters for subsequent intraperitoneal therapy.
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The role of chemotherapy and prophylactic bilateral oophorectomy in a case of colorectal adenocarcinoma with ovarian metastases. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2001; 74:101-5. [PMID: 11393261 PMCID: PMC2588692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A 66-year-old female presented with a large abdominal mass and accompanying systemic complaints of abdominal pain, constipation. and fever. On exploratory laparotomy, the mass was found to be a moderately differentiated adenocarcinoma of the sigmoid colon with metastasis to the left ovary. A primary colorectal carcinoma that has metastasized to the ovaries can be difficult to distinguish clinically from an advanced primary ovarian tumor. Histology and tumor markers are currently the most useful tools available in making an accurate diagnosis. If the nature of the primary tumor is uncertain and the initial response to chemotherapy is poor, the patient's prognosis will also he poor. Though controversy exists regarding the role of prophylactic bilateral oophorectomy during resection for primary colorectal cancer, later confusion can be avoided by performing this procedure when the colorectal carcinoma is first diagnosed. However the possibility of a concurrent primary ovarian tumor must not be overlooked.
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The use of Polaroid TPX radiographic film for light localisation-radiation fields coincidence testing. Phys Med Biol 2000. [DOI: 10.1088/0031-9155/35/1/011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Comparison of urinary hyperglycosylated human chorionic gonadotropin concentration with the serum triple screen for Down syndrome detection in high-risk pregnancies. Am J Obstet Gynecol 2000; 183:1114-8. [PMID: 11084551 DOI: 10.1067/mob.2000.108884] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Both modest screening performance and declining patient and physician acceptance have stimulated interest in alternative markers to the triple screen for the detection of Down syndrome. Our purpose was to compare the concentration of a single urinary analyte, hyperglycosylated human chorionic gonadotropin, with the serum triple screen (alpha-fetoprotein, human chorionic gonadotropin, and unconjugated estriol concentrations combined with age) for second-trimester Down syndrome detection. STUDY DESIGN Urine and blood were obtained from pregnant women in the second trimester undergoing genetic amniocentesis. Urinary hyperglycosylated human chorionic gonadotropin concentration and serum triple-screen values were measured. Individuals undergoing amniocentesis because of abnormal triple-screen results were excluded. Individual Down syndrome risks on the basis of urinary hyperglycosylated human chorionic gonadotropin concentration plus maternal age and on the basis of the triple-screen results were calculated. For each algorithm the sensitivity and false-positive rate for Down syndrome detection at different risk thresholds were determined. From these values receiver operating characteristic curves were constructed, and the area under the curve was determined for each algorithm. Finally, the performance of a new combination in which urinary hyperglycosylated human chorionic gonadotropin concentration replaced serum human chorionic gonadotropin concentration in the triple screen was ascertained. RESULTS We studied 24 pregnancies complicated by Down syndrome and 500 unaffected pregnancies between 14 and 22 weeks' gestation in a mostly white (93.5%) population undergoing amniocentesis primarily because of advanced maternal age. The sensitivity and false-positive rate for urinary hyperglycosylated human chorionic gonadotropin concentration were 75. 0% and 5.6%, respectively, whereas those for the triple screen were 75.0% and 33.2%, respectively. Urinary hyperglycosylated human chorionic gonadotropin concentration was superior to the triple screen (area under the curve, 0.9337 vs 0.7887; P =.02). The substitution of urinary hyperglycosylated human chorionic gonadotropin concentration for serum human chorionic gonadotropin concentration in the triple screen resulted in a 91.7% sensitivity at a 10.0% false-positive rate, versus a 54.2% sensitivity for the traditional triple screen at the same false-positive rate. CONCLUSION The performance of urinary hyperglycosylated human chorionic gonadotropin concentration was statistically superior to that of the serum triple screen in a high-risk population. The use of urinary hyperglycosylated human chorionic gonadotropin concentration as an alternative test or substitution of this measurement for serum human chorionic gonadotropin concentration in the triple screen would improve diagnostic accuracy and address many current concerns related to the triple screen.
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Spontaneous rupture of a splenic artery aneurysm in pregnancy: report of two cases. Acta Chir Belg 2000; 100:231-3. [PMID: 11143328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
The spontaneous rupture of a splenic artery aneurysm during pregnancy is a rare but catastrophic event. Two cases are reported, both involving fetal death and one maternal death as well. A review of the literature covering this condition shows that mortality amongst pregnant women remains high at 75% with 95% fetal loss, which compares with a 25% mortality rate amongst non-pregnant women. Clinical presentation is often non-specific, with good haemodynamic compensation, followed by a rapid deterioration. The best investigation appears to be a diagnostic laparotomy. The discussion stresses the importance of early diagnosis faced with this serious condition, as well as the potential benefits of a prompt lower mid-line incision in terms of statistical survival for both mother and fetus.
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Urine hyperglycosylated hCG plus ultrasound biometry for detection of down syndrome in the second trimester in a high-risk population. Obstet Gynecol 2000; 95:889-94. [PMID: 10831986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
OBJECTIVE To evaluate measurement of levels of urine hyperglycosylated hCG, a form of hCG with abnormally branched oligosaccharide side chains, in conjunction with ultrasound biometry for Down syndrome risk prediction in an at-risk group. METHOD We prospectively measured urine hyperglycosylated hCG levels, humeral length, and nuchal thickness in women who had second-trimester amniocentesis. Urine hyperglycosylated hCG levels were measured by a two-step enzyme-immunometric assay using monoclonal antibody beta152. Humeral length, nuchal thickness, and hyperglycosylated hCG values were expressed as multiples of the median, and the Down syndrome screening efficiency of the three analytes plus age was determined. A receiver operating characteristic (ROC) curve was generated, and the area under the curve was used to assess the Down syndrome screening performance of the algorithm. RESULTS There were 23 cases of Down syndrome among 1016 singleton pregnancies. Mean gestational age (+/- standard deviation) was 16.1 +/- 1.2 weeks at the time of amniocentesis. Mean maternal age was 37.1 +/- 3.2 years. Biometry and measurement of hyperglycosylated hCG levels had a 91.3% detection rate at a 3.2% false-positive rate and a 100% detection rate at a 10.7% false-positive rate. The area under the ROC curve was 0.986 (P <.001), and that for measurement of hyperglycosylated hCG levels plus age was 0.941 (P <.001). The area under the curve was significantly larger with combined biochemical and biometry markers compared with measurement of hyperglycosylated hCG levels plus age alone (P <.02), proving that the former was superior to the latter. CONCLUSION A new Down syndrome biochemical marker combined with ultrasound biometry had a high screening efficiency in a high-risk group. All cases of Down syndrome in this study population would have been detected at an amniocentesis rate of less than 10.7%. Our results appear superior to those found with other second-trimester algorithms. The combination is promising as an alternative to "automatic" genetic amniocentesis in women of advanced maternal age and other high-risk groups.
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Hyperglycosylated human chorionic gonadotropin (invasive trophoblast antigen) immunoassay: A new basis for gestational Down syndrome screening. Clin Chem 1999; 45:2109-19. [PMID: 10585342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
BACKGROUND Serum human chorionic gonadotropin (hCG) and hCG free beta-subunit tests are used in combination with unconjugated estriol and alpha-fetoprotein in the triple screen test, and with the addition of inhibin-A in the quadruple marker test for detecting Down syndrome in the second trimester of pregnancy. These tests have a limited detection rate for Down syndrome: approximately 40% for hCG or free beta-subunit alone, approximately 60% for the triple screen test, and approximately 70% for the quadruple marker test, all at 5%, or a relatively high, false-positive rate. New tests are needed with higher detection and lower false rates. Hyperglycosylated hCG (also known as invasive trophoblast antigen or ITA) is a new test. It specifically detects a unique oligosaccharide variant of hCG associated with Down syndrome pregnancies. We evaluated this new Down syndrome-directed test in prenatal diagnosis. METHODS Hyperglycosylated hCG was measured in urine samples from women undergoing amniocentesis for advanced maternal age concerns at 14-22 weeks of gestation, 1448 with normal karyotype and 39 with Down syndrome fetuses. RESULTS The median hyperglycosylated hCG value was 9.5-fold higher in Down syndrome cases (9.5 multiples of the normal karyotype median). The single test detected 80% of Down syndrome cases at a 5% false-positive rate. Urine hyperglycosylated hCG was combined with urine beta-core fragment (urine breakdown product of serum hCG free beta-subunit), serum alpha-fetoprotein, and maternal age-related risk. This urine-serum combination detected 96% of Down syndrome cases at a 5% false-positive rate, 94% of cases at a 3% false-positive rate, and 71% of cases at a 1% false-positive rate. These detection rates exceed those of any previously reported combination of biochemical markers. CONCLUSIONS Hyperglycosylated hCG is a new base marker for Down syndrome screening in the second trimester of pregnancy. The measurement of hyperglycosylated hCG can fundamentally improve the performance of Down syndrome screening protocols.
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Maternal urine hyperglycosylated hCG in pregnancies with Down syndrome. Prenat Diagn 1999; 19:918-20. [PMID: 10521815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Stored maternal urine samples were used to determine the distribution of hyperglycosylated human chorionic gonadotrophin (H-hCG) levels in pregnancies with Down syndrome. A total of 349 samples from singleton pregnancies, including 45 with Down syndrome, were tested at 10-19 weeks' gestation. Urinary concentration was allowed for by expressing H-hCG in ng per mmol creatinine. The median level in Down syndrome was 3.63 multiples of the gestation-specific median in unaffected pregnancies (p<0.0001, Wilcoxon rank-sum test, two-tail). However, creatinine levels were relatively low in cases and creatinine did not fully correct for concentration. When this bias was allowed for, the median level was 3.34 multiples of the normal median (MoM). The H-hCG elevation in affected pregnancies was more marked at 14 weeks' gestation or later: a median of 4.64 MoM and allowing for creatinine bias 4.46 MoM.
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