Magliozzo, M., Tumminia, A., Arpi, M. L., Deiana, E., Guglielmo, M., Giannone, G., Frasca, F., and Gullo, D.
Abstract
Introduction: Insulinomas represent the most common functional pancreatic neuroendocrine tumors. Following preoperative localization, surgical excision is the curative treatment. It may be difficult to confirm a complete resection of insulinoma. We used intermittently scanned continuous glucose monitoring (isCGM) to record the fluctuation of interstitial glucose throughout surgery to help verify the tumor’s complete surgical excision. Materials and methods: In five individuals with insulinoma undergoing laparoscopic surgery we used the isCGM system (Freestyle Libre 2 Abbott) during tumor removal in order for the surgeon to understand “in real-time” the extent of tumor removal. Results: Two patients received no preoperative treatment, while three patients received medical treatment with either lanreotide (2 patients) or diazoxide (1 patient). In the non-treated patients, following tumor resection, there was a rapid interstitial glucose increase along with stabilized glucose levels thoroughly documented by intraoperative isCGM. Lanreotide treatment, on the other hand, resulted in only a minor increase in interstitial glucose. Finally, diazoxide-treated patients had a response that was intermediate between lanreotide-treated and non-treated patients. Conclusion: Our findings suggest that isCGM is a useful tool to monitor the outcome of surgery during pancreatic insulinoma excision, assisting the surgical team in successfully removing the tumor. Despite the limited sample size, the results are promising, and, if validated in larger studies, they make us believe that the use of CGM systems has a definite benefit for becoming a standard in the surgical treatment of insulinomas.
Panda, Cristian D., Tao, Matthew J., Ceja, Miguel, Khoury, Justin, Tino, Guglielmo M., and Müller, Holger
Abstract
Despite being the dominant force of nature on large scales, gravity remains relatively elusive to precision laboratory experiments. Atom interferometers are powerful tools for investigating, for example, Earth’s gravity1, the gravitational constant2, deviations from Newtonian gravity3–6and general relativity7. However, using atoms in free fall limits measurement time to a few seconds8, and much less when measuring interactions with a small source mass2,5,6,9. Recently, interferometers with atoms suspended for 70 s in an optical-lattice mode filtered by an optical cavity have been demonstrated10–14. However, the optical lattice must balance Earth’s gravity by applying forces that are a billionfold stronger than the putative signals, so even tiny imperfections may generate complex systematic effects. Thus, lattice interferometers have yet to be used for precision tests of gravity. Here we optimize the gravitational sensitivity of a lattice interferometer and use a system of signal inversions to suppress and quantify systematic effects. We measure the attraction of a miniature source mass to be amass= 33.3 ± 5.6stat± 2.7systnm s−2, consistent with Newtonian gravity, ruling out ‘screened fifth force’ theories3,15,16over their natural parameter space. The overall accuracy of 6.2 nm s−2surpasses by more than a factor of four the best similar measurements with atoms in free fall5,6. Improved atom cooling and tilt-noise suppression may further increase sensitivity for investigating forces at sub-millimetre ranges17,18, compact gravimetry19–22, measuring the gravitational Aharonov–Bohm effect9,23and the gravitational constant2, and testing whether the gravitational field has quantum properties24.
Actis Dato, Guglielmo M., De Paulis, Ruggero, Actis Dato, Alberto, Bassano, Carlo, Pepe, Nicola, Borioni, Raoul, and Panero, Giovanni B.
Subjects
Funnel chest, Chest -- Surgery, Surgery, Health
Abstract
Between June 1958 and December 1991, 315 patients (217 male and 98 female, mean age=17.8 ± 5.5 years) affected by pectus excavatum (PE) were surgically treated. Most of the patients [...]
Dato, Guglielmo M. Actis, Cavaglia, M., and Poletti, G.A.
Subjects
Implants, Artificial, Prosthesis, Endocarditis, Antibiotics, Health
Abstract
Byline: Guglielmo M. Actis Dato, M. Cavaglia, G.A. Poletti Author Affiliation: Italian Institution of Cardiac Surgery Via Genova, 4 Torino 10126, Italy
Penso, M, Babbaro, M, Guglielmo, M, Baggiano, A, Moccia, S, Pepi, M, Fusini, L, Carerj, L, Andreini, D, Caiani, E, and Pontone, G
Abstract
Diagnosis of myocardial fibrosis has a relevant prognostic and therapeutic role. Scar–tissue analysis is commonly performed with late gadolinium contrast–enhanced (CE) cardiac magnetic resonance (CMR). However, CMR might be contraindicated or unavailable. Coronary computed tomography (CCT), which is the technique of choice for many routine assessments, is emerging as an alternative to CMR. The objective of this study is to evaluate whether artificial intelligence (AI) could allow identification of myocardial fibrosis from routine early CE–CCT images. Fifty consecutive patients with left ventricular dysfunction (LVD), who underwent both CE–CMR and (early and late) CE–CCT were retrospectively selected. According to the late enhancement CMR patterns, patients were classified as with ischemic (n=15, 30%) or non–ischemic (n=25, 70%) LVD. Scar regions were manually traced on late CE–CCT using CE–CMR as ground–truth. On early CE–CCT images, the myocardial sectors were extracted according to AHA 16–segment model and labeled as with scar or not based on the late CE–CCT manual tracing. A deep–learning model was developed to classify each sector (Picture 1). Of the initial 44187 sectors computed out of the 8285 slices available from the early CE–CCT images, 4594 sectors (10%) presented scar. The CNN approach on the early CE–CCT images yielded a classification accuracy for all sectors of 71% (95% confidence interval (CI): 63%–79%) obtained through 5–fold cross validation. The mean sensitivity, positive predictive value (PPV) and negative predictive value (NPV) for the testing fold resulted in 73% (95% CI: 66%–79%), 56% (95% CI: 48%–65%) and 85% (95% CI: 82%– 88%), respectively. The mean AUC across the five folds was 76% (95% CI: 72%–81%). In a per–segment analysis of the 16–segment AHA model the bull’s eye segmental comparison of CE–CMR and respective early CE–CCT findings an 91% agreement was achieved (Picture 2). Artificial intelligence can detect both ischemic and non–ischemic myocardial fibrosis from routine noninvasive coronary scans, without additional contrast–agent administration or radiational dose, thus assisting diagnosis and management of patients with LV dysfunction and coronary artery disease.
Tarallo, Marco G., Poli, Nicola, Wang, F.-Y., Tino, Guglielmo M., Tarallo, Marco G., Poli, Nicola, Wang, F.-Y., and Tino, Guglielmo M.
Abstract
Amplitude modulation of a tilted optical lattice can be used to steer the quantum transport of matter wave packets in a very flexible way. This allows the experimental study of the phase sensitivity in a multimode interferometer based on delocalization-enhanced Bloch oscillations and to probe the band structure modified by a constant force.
We summarise the discussions at a virtual Community Workshop on Cold Atoms in Space concerning the status of cold atom technologies, the prospective scientific and societal opportunities offered by their deployment in space, and the developments needed before cold atoms could be operated in space. The cold atom technologies discussed include atomic clocks, quantum gravimeters and accelerometers, and atom interferometers. Prospective applications include metrology, geodesy and measurement of terrestrial mass change due to, e.g., climate change, and fundamental science experiments such as tests of the equivalence principle, searches for dark matter, measurements of gravitational waves and tests of quantum mechanics. We review the current status of cold atom technologies and outline the requirements for their space qualification, including the development paths and the corresponding technical milestones, and identifying possible pathfinder missions to pave the way for missions to exploit the full potential of cold atoms in space. Finally, we present a first draft of a possible road-map for achieving these goals, that we propose for discussion by the interested cold atom, Earth Observation, fundamental physics and other prospective scientific user communities, together with the European Space Agency (ESA) and national space and research funding agencies.
De Filippo, E, Marra, M, Alfinito, F, Di Guglielmo, M L, Majorano, P, Cerciello, G, De Caprio, C, Contaldo, F, and Pasanisi, F
Abstract
Background/objectives:Anemia, leukopenia and, although less frequently, thrombocytopenia are possible hematological complications of anorexia nervosa considered strictly secondary to chronic malnutrition. This is a retrospective study on the prevalence of these disorders in a large cohort of 318 female patients with AN (20.4±5.6 years, body mass index (BMI) 15.9±1.6 kg/m2), recruited in the Outpatient Unit for Malnutrition secondary to Eating Disorders at the Department of Clinical Medicine and Surgery, Federico II University Hospital, since February 1991 to December 2012.Subjects/methods:Patients were studied on an outpatient basis after obtaining medical history, clinical examination, routine hematobiochemical and endocrine tests, electrocardiography, psychiatric interview and bioelectrical impedance analysis and, in particular, phase angle determination. All patients with other comorbidities, in particular with mean corpuscular volume <80 fl, were excluded for suspected genetic alteration in the synthesis of hemoglobin.Results:Hematologic data showed that 16.7% of patients had anemia, 7.9% neutropenia and 8.9% thrombocytopenia. These abnormalities were strictly related to the duration of illness (P=0.028), and to protein energy malnutrition, in particular, BMI and phase angle (P<0.001).Conclusions:Our study offers description of the incidence of hematologic defects in a selected and large sample of AN female patients, suggesting that its incidence is related to the degree and duration of protein energy malnutrition.
Amelotti, N, Mapelli, M, Pires, I, Guglielmo, M, Majocchi, B, Catto, V, Campodonico, J, Vignati, C, Baggiano, A, Ribatti, V, Moltrasio, M, Vettor, G, Sicuso, R, Pontone, G, Basso, C, and Agostoni, P
Coppola, G., Carità, P., Corrado, E., Borrelli, A., Rotolo, A., Guglielmo, M., Nugara, C., Ajello, L., Santomauro, M., and Novo, S.
Abstract
Chest pain is one of the chief presenting complaints among patients attending Emergency department. The diagnosis of acute myocardial infarction may be a challenge. Various tools such as anamnesis, blood sample (with evaluation of markers of myocardial necrosis), ultrasound techniques and coronary computed tomography could be useful. However, the interpretation of electrocardiograms of these patients may be a real concern. The earliest manifestations of myocardial ischemia typically interest T waves and ST segment. Despite the high sensitivity, ST segment deviation has however poor specificity since it may be observed in many other cardiac and non-cardiac conditions. Therefore, when ST–T abnormalities are detected the physicians should take into account many other parameters (such as risk factors, symptoms and anamnesis) and all the other differential diagnoses. The aim of our review is to overview of the main conditions that may mimic a ST segment Elevation Myocardial Infarction (STEMI).
Trovato, Guglielmo M., Martines, Giuseppe Fabio, Pirri, Clara, Trovato, Francesca M., Castro, Angelo, Garozzo, Adriana, and Catalano, Daniela
Abstract
Adenoviruses Ad36 and Ad37 increase adiposity in animals and are associated with obesity in humans; effects on the liver have been reported. The association of Adenovirus Ad36 seropositivity (Ad36) with obesity but not with the severity of nonalcoholic fatty liver disease (NAFLD) has been previously shown. We investigate whether nondiabetic Ad37 patients show a different prevalence of NAFLD and ultrasound Bright Liver score.
Iwata, Yohei, Matsushita, Takashi, Horikawa, Mayuka, DiLillo, David J., Yanaba, Koichi, Venturi, Guglielmo M., Szabolcs, Paul M., Bernstein, Steven H., Magro, Cynthia M., Williams, Armistead D., Hall, Russell P., St Clair, E. William, and Tedder, Thomas F.
Abstract
Regulatory B cells control inflammation and autoimmunity in mice, including the recently identified IL-10–competent B10 cell subset that represents 1% to 3% of spleen B cells. In this study, a comparable IL-10–competent B10 cell subset was characterized in human blood. B10 cells were functionally identified by their ability to express cytoplasmic IL-10 after 5 hours of ex vivo stimulation, whereas progenitor B10 (B10pro) cells required 48 hours of in vitro stimulation before they acquired the ability to express IL-10. B10 and B10pro cells represented 0.6% and approximately 5% of blood B cells, respectively. Ex vivo B10 and B10pro cells were predominantly found within the CD24hiCD27+ B-cell subpopulation that was able to negatively regulate monocyte cytokine production through IL-10–dependent pathways during in vitro functional assays. Blood B10 cells were present in 91 patients with rheumatoid arthritis, systemic lupus erythematosus, primary Sjögren syndrome, autoimmune vesiculobullous skin disease, or multiple sclerosis, and were expanded in some cases as occurs in mice with autoimmune disease. Mean B10 + B10pro-cell frequencies were also significantly higher in patients with autoimmune disease compared with healthy controls. The characterization of human B10 cells will facilitate their identification and the study of their regulatory activities during human disease.
Dato, Guglielmo M. Actis, De Paulis, Ruggero, Dato, Alberto Actis, Bassano, Carlo, Pepe, Nicola, Borioni, Raoul, and Panero, Giovanni B.
Abstract
Between June 1958 and December 1991, 315 patients (217 male and 98 female, mean age=17.8±5.5 years) affected by pectus excavatum (PE) were surgically treated. Most of the patients required operation for aesthetic reasons only (299 patients; 95 percent). The grade of PE (Chin classification) was I in 72 patients, II in 152, and III in the remaining 91. The surgical technique consisted of a double transversal sternotomy at the level of the lowest and highest part of the depression associated with a longitudinal sternotomy. A wedge resection of the ribs was then performed and the sternum was fixed using a stainless steel strut molded into a seagull wing prosthesis. The strut was removed 12 months postoperatively. There were no operative mortalities. Four patients had sternal wound infection that was successfully treated. The mean follow-up was 15.8 years per patient and was 60 percent complete. From the aesthetic point of view, the postoperative results were excellent in 246 patients (78 percent), good in 57 (18 percent), and poor in 12 (4 percent). All subjective symptoms, when present, disappeared after surgery. The seagull wing prosthesis appears to be safe, easy to implant and to remove, and comfortable for the patient. This technique has shown good long-term results independently of type of deformity and patient age.
https://www.ncbi.nlm.nih.gov/pubmed?term=27679600 - Conte E, Annoni A, Pontone G, Mushtaq S, Guglielmo M, Baggiano A, Volpato V, Agalbato C, Bonomi A, Veglia F, Formenti A, Fiorentini C, Bartorelli AL, Pepi M, Andreini D. Evaluation of coronary plaque characteristics with coronary computed tomography angiography in patients with non-obstructive coronary artery disease: a long-term follow-up study. While the management of patients with obstructive CAD is established, as it revolves around further diagnostic test for ischemia evaluation or upfront coronary artery revascularization, this is not the case for patients with non-obstructive CAD. [Extracted from the article]
Domingos, JS, Augustine, DX, Leeson, P, Noble, JA, Doan, H-L, Boubrit, L, Cheikh-Khalifa, R, Laveau, F, Djebbar, M, Pousset, F, Isnard, R, Hammoudi, N, Lisi, M, Cameli, M, Di Tommaso, C, Curci, V, Reccia, R, Maccherini, M, Henein, M Y, Mondillo, S, Leitman, M, Vered, Z, Rashid, H, Yalcin, M U, Gurses, K M, Kocyigit, D, Evranos, B, Yorgun, H, Sahiner, L, Kaya, B, Aytemir, K, Ozer, N, Bertella, E, Petulla', M, Baggiano, A, Mushtaq, S, Russo, E, Gripari, P, Innocenti, E, Andreini, D, Tondo, C, Pontone, G, Necas, J, Kovalova, S, Hristova, K, Shiue, I, Bogdanva, V, Teixido Tura, G, Sanchez, V, Rodriguez-Palomares, J, Gutierrez, L, Gonzalez-Alujas, T, Garcia-Dorado, D, Forteza, A, Evangelista, A, Timoteo, A T, Aguiar Rosa, S, Cruz Ferreira, R, Campbell, R, Carrick, D, Mccombe, C, Tzemos, N, Berry, C, Sonecki, P, Noda, M, Setoguchi, M, Ikenouchi, T, Nakamura, T, Yamamoto, Y, Murakami, T, Katou, Y, Usui, M, Ichikawa, K, Isobe, M, Kwon, BJ, Roh, JW, Kim, HY, Ihm, SH, Barron, A J, Francis, DP, Mayet, J, Wensel, R, Kosiuk, J, Dinov, B, Bollmann, A, Hindricks, G, Breithardt, OA, Rio, P, Moura Branco, L, Galrinho, A, Cacela, D, Pinto Teixeira, P, Afonso Nogueira, M, Pereira-Da-Silva, T, Abreu, J, Teresa Timoteo, A, Cruz Ferreira, R, Pavlyukova, EN, Tereshenkova, EK, Karpov, RS, Piatkowski, R, Kochanowski, J, Opolski, G, Barbier, P, Mirea, O, Guglielmo, M, Savioli, G, Cefalu, C, Pudil, R, Horakova, L, Rozloznik, M, Balestra, C, P37/03, PRVOUK, Rimbas, RC, Enescu, OA, Calin, S, Vinereanu, D, POSDRU/159/1.5/S/141531, Grant, Karsenty, C, Hascoet, S, Hadeed, K, Semet, F, Dulac, Y, Alacoque, X, Leobon, B, Acar, P, Dharma, S, Sukmawan, R, Soesanto, AM, Vebiona, KPP, Firdaus, I, Danny, SS, Driessen, M M P, Sieswerda, GTJ, Post, MC, Snijder, RJ, Van Dijk, APJ, Leiner, T, Meijboom, FJ, Chrysohoou, C, Tsitsinakis, G, Tsiachris, D, Aggelis, A, Herouvim, E, Vogiatzis, I, Pitsavos, C, Koulouris, G, Stefanadis, C, Erdei, T, Edwards, J, Braim, D, Yousef, Z, Fraser, AG, Cardiff, Investigators, MEDIA, Avenatti, E, Magnino, C, Omede', P, Presutti, D, Moretti, C, Iannaccone, A, Ravera, A, Gaita, F, Milan, A, Veglio, F, Barbier, P, Scali, MC, Simioniuc, A, Guglielmo, M, Savioli, G, Cefalu, C, Mirea, O, Fusini, L, Dini, F, Okura, H, Murata, E, Kataoka, T, Mikaelpoor, A, Ojaghi Haghighi, SH, Ojaghi Haghighi, SZ, Alizadeasl, A, Sharifi-Zarchi, A, Zaroui, A, Ben Halima, M, Mourali, MS, Mechmeche, R, Rodriguez Palomares, J F, Gutierrez, LG, Maldonado, GM, Garcia, GG, Otaegui, IO, Garcia Del Blanco, BGB, Teixido, GT, Gonzalez Alujas, MTGA, Evangelista, AE, Garcia Dorado, DGD, Godinho, A R, Correia, AS, Rangel, I, Rocha, A, Rodrigues, J, Araujo, V, Almeida, PB, Macedo, F, Maciel, MJ, Rekik, B, Mghaieth, F, Aloui, H, Boudiche, S, Jomaa, M, Ayari, J, Tabebi, N, Farhati, A, Mourali, S, Dekleva, M, Markovic-Nikolic, N, Zivkovic, M, Stankovic, A, Boljevic, D, Korac, N, Beleslin, B, Arandjelovic, A, Ostojic, M, Galli, E, Guirette, Y, Auffret, V, Daudin, M, Fournet, M, Mabo, P, Donal, E, Chin, C W L, Luo, E, Hwan, J, White, A, Newby, D, Dweck, M, Carstensen, H G, Larsen, L H, Hassager, C, Kofoed, K F, Jensen, J S, Mogelvang, R, Kowalczyk, M, Debska, M, Kolesnik, A, Dangel, J, Kawalec, W, Migliore, RA, Adaniya, ME, Barranco, MA, Miramont, G, Gonzalez, S, Tamagusuku, H, Davidsen, E S, Kuiper, K K J, Matre, K, Gerdts, E, Igual Munoz, B, Maceira Gonzalez, AMG, Erdociain Perales, MEP, Estornell Erill, JEE, Valera Martinez, FVM, Miro Palau, VMP, Piquer Gil, MPG, Sepulveda Sanchez, PSS, Cervera Zamora, ACZ, Montero Argudo, AMA, Placido, R, Silva Marques, J, Magalhaes, A, Guimaraes, T, Nobre E Menezes, M, Goncalves, S, Ramalho, A, Robalo Martins, S, Almeida, AG, Nunes Diogo, A, Abid, L, Ben Kahla, S, Charfeddine, S, Abid, D, Kammoun, S, Tounsi, A, Abid, LEILA, Abid, DORRA, Charfeddine, SALMA, Hammami, RANIA, Triki, FETEN, Akrout, MALEK, Mallek, SOUAD, Hentati, MOURAD, Kammoun, SAMIR, Sirbu, C F, Berrebi, A, Huber, A, Folliguet, T, Yang, L-T, Shih, JY, Liu, YW, Li, YH, Tsai, LM, Luo, CY, Tsai, WC, Babukov, R, Bartosh, F, Bazilev, V, Muraru, D, Cavalli, G, Addetia, K, Miglioranza, MH, Veronesi, F, Mihaila, S, Tadic, M, Cucchini, U, Badano, L, Lang, RM, Miyazaki, S, Slavich, M, Miyazaki, T, Figini, F, Lativ, A, Chieffo, A, Montrfano, M, Alfieri, O, Colombo, A, Agricola, E, Liu, D, Hu, K, Herrmann, S, Stoerk, S, Kramer, B, Ertl, G, Bijnens, B, Weidemann, F, Brand, M, Butz, T, Tzikas, S, Van Bracht, M, Roeing, J, Wennemann, R, Christ, M, Grett, M, Trappe, H-J, Scherzer, S, Geroldinger, AG, Krenn, L, Roth, C, Gangl, C, Maurer, G, Rosenhek, R, Neunteufl, T, Binder, T, Bergler-Klein, J, Martins, E, Pinho, T, Leite, S, Azevedo, O, Belo, A, Campelo, M, Amorim, S, Rocha-Goncalves, F, Goncalves, L, Silva-Cardoso, J, Ahn, HS, Kim, KT, Jeon, HK, Youn, HJ, Haland, T, Saberniak, J, Leren, IS, Edvardsen, T, Haugaa, KH, Ziolkowska, L, Boruc, A, Kowalczyk, M, Turska-Kmiec, A, Zubrzycka, M, Kawalec, W, Monivas Palomero, V, Mingo Santos, S, Goirigolzarri Artaza, J, Rodriguez Gonzalez, E, Rivero Arribas, B, Castro Urda, V, Dominguez Rodriguez, F, Mitroi, C, Gracia Lunar, I, Fernadez Lozano, I, Palecek, T, Masek, M, Kuchynka, P, Fikrle, M, Spicka, I, Rysava, R, Linhart, A, Saberniak, J, Hasselberg, NE, Leren, IS, Haland, T, Borgquist, R, Platonov, PG, Edvardsen, T, Haugaa, KH, Ancona, R, Comenale Pinto, S, Caso, P, Coopola, MG, Arenga, F, Rapisarda, O, D'onofrio, A, Sellitto, V, Calabro, R, Rosca, M, Popescu, BA, Calin, A, Mateescu, A, Beladan, CC, Jalba, M, Rusu, E, Zilisteanu, D, Ginghina, C, Pressman, G, Cepeda-Valery, B, Romero-Corral, A, Moldovan, R, Saenz, A, Orban, M, Samuel, SP, Fijalkowski, M, Fijalkowska, M, Gilis-Siek, N, Blaut, K, Galaska, R, Sworczak, K, Gruchala, M, Fijalkowski, M, Nowak, R, Gilis-Siek, N, Fijalkowska, M, Galaska, R, Gruchala, M, Ikonomidis, I, Triantafyllidi, H, Trivilou, P, Tzortzis, S, Papadopoulos, C, Pavlidis, G, Paraskevaidis, I, Lekakis, J, Padiyath, A, Li, L, Xiao, Y, Danford, DA, Kutty, S, Kaymaz, C, Aktemur, T, Poci, N, Ozturk, S, Akbal, O, Yilmaz, F, Tokgoz Demircan, HC, Kirca, N, Tanboga, IH, Ozdemir, N, Investigators, EUPHRATES, Greiner, S, Jud, A, Aurich, M, Hess, A, Hilbel, T, Hardt, S, Katus, HA, D'ascenzi, F, Cameli, M, Alvino, F, Lisi, M, Focardi, M, Solari, M, Bonifazi, M, Mondillo, S, Konopka, M, Krol, W, Klusiewicz, A, Burkhard, K, Chwalbinska, J, Pokrywka, A, Dluzniewski, M, Braksator, W, King, G J, Coen, K, Gannon, S, Fahy, N, Kindler, H, Clarke, J, Iliuta, L, Rac-Albu, M, Placido, R, Robalo Martins, S, Guimaraes, T, Nobre E Menezes, M, Cortez-Dias, N, Francisco, A, Silva, G, Goncalves, S, Almeida, AG, Nunes Diogo, A, Kyu, K, Kong, WKF, Songco, GG, Galupo, MJ, Castro, MD, Shin Hnin, W, Ronald Lee, CH, Poh, KK, Milazzo, V, Di Stefano, C, Tosello, F, Leone, D, Ravera, A, Sabia, L, Sobrero, G, Maule, S, Veglio, F, Milan, A, Jamiel, A M, Ahmed, A M, Farah, I, Al-Mallah, M H, Petroni, R, Magnano, R, Bencivenga, S, Di Mauro, M, Petroni, S, Altorio, SF, Romano, S, Penco, M, Kumor, M, Lipczynska, M, Klisiewicz, A, Wojcik, A, Konka, M, Kozuch, K, Szymanski, P, Hoffman, P, Rimbas, RC, Rimbas, M, Enescu, OA, Mihaila, S, Calin, S, Vinereanu, D, 112/2011, Grant CNCSIS, 159/1.5/S/141531, Grant POSDRU, Donal, E, Reynaud, A, Lund, LH, Persson, H, Hage, C, Oger, E, Linde, C, Daubert, JC, investigators, KaRen, Maria Oliveira Lima, M, Costa, H, Gomes Da Silva, M, Noman Alencar, MC, Carmo Pereira Nunes, M, Costa Rocha, MO, Abid, L, Charfeddine, S, Ben Kahla, S, Abid, D, Siala, A, Hentati, M, Kammoun, S, Kovalova, S, Necas, J, Ozawa, K, Funabashi, N, Takaoka, H, Kobayashi, Y, Matsumura, Y, Wada, M, Hirakawa, D, Yasuoka, Y, Morimoto, N, Takeuchi, H, Kitaoka, H, Sugiura, T, Lakkas, L, Naka, KK, Ntounousi, E, Gkirdis, I, Koutlas, V, Bechlioulis, A, Pappas, K, Katsouras, CS, Siamopoulos, K, Michalis, LK, Naka, KK, Evangelou, D, Kalaitzidis, R, Bechlioulis, A, Lakkas, L, Gkirdis, I, Tzeltzes, G, Nakas, G, Katsouras, CS, Michalis, LK, Generati, G, Bandera, F, Pellegrino, M, Labate, V, Alfonzetti, E, Guazzi, M, Zagatina, A, Zhuravskaya, N, Al-Mallah, M, Alsaileek, A, Qureshi, W, Karsenty, C, Hascoet, S, Peyre, M, Hadeed, K, Alacoque, X, Amadieu, R, Leobon, B, Dulac, Y, Acar, P, Yamanaka, Y, Sotomi, Y, Iwakura, K, Inoue, K, Toyoshima, Y, Tanaka, K, Oka, T, Tanaka, N, Orihara, Y, Fujii, K, Soulat-Dufour, L, Lang, S, Boyer-Chatenet, L, Van Der Vynckt, C, Ederhy, S, Adavane, S, Haddour, N, Boccara, F, Cohen, A, Huitema, MP, Boerman, S, Vorselaars, VMM, Grutters, JC, Post, MC, Gopal, A S, Saha, SK, Toole, RS, Kiotsekoglou, A, Cao, JJ, Reichek, N, Meyer, C G, Altiok, E, Al Ateah, G, Lehrke, M, Becker, M, Lotfi, S, Autschbach, R, Marx, N, Hoffmann, R, Frick, M, Nemes, A, Sepp, R, Kalapos, A, Domsik, P, Forster, T, Caro Codon, J, Blazquez Bermejo, Z, Lopez Fernandez, T, Valbuena Lopez, S C, Iniesta Manjavacas, A M, De Torres Alba, F, Dominguez Melcon, F, Pena Conde, L, Moreno Yanguela, M, Lopez-Sendon, J L, Nemes, A, Lengyel, C, Domsik, P, Kalapos, A, Orosz, A, Varkonyi, TT, 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Abstract
Purpose: 3D echocardiography (3DE) enables fast 3D acquisition but subsequent manual navigation to find 2D diagnostic planes can be time consuming. We have developed and validated an automated machine learning-based technique to find apical 2-, 3- and 4-chamber (A2C, A3C, A4C) views that enables fast volume navigation and analysis. Methods: 3DE volumes were acquired (Philips iE33: X3-1 and X5-1 probes) from 30 healthy volunteers and 36 clinical patients with suspected valve disease and coronary heart disease. 66 end diastolic volumes were used to assess the accuracy of apical standard view finding by our method against manual plane finding. To do this, dedicated software was developed with a machine learning approach and a 3-fold cross validation of results was performed. Results: Automatic A4C view detection was possible in 60/66 (91%) of volumes; detection failures were due to suboptimal myocardium wall integrity or lack of right ventricle in the scan. A2C and A3C views were extracted from the A4C view using the known geometrical relationships between apical standard views (A2C to A3C: 30°~40° and A2C to A4C: 90° of rotation over the left ventricle long axis, as shown in the Figure). In average, our method accurately found the heart apex and mitral valve centre with a 7.1 ± 5.7 mm and 7.2 ± 5.3 mm error, respectively. Conclusions: In order to automate clinical workflow, we have developed a new and fully automatic machine learning strategy for apical standard view finding which performed well (91% detection accuracy) on volunteer and clinical 3D echocardiograms. Figure
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Vascular, University, Semmelweis, Budapest, Hungary, and Group, MTA-SE Lendület Cardiovascular Imaging Research
Abstract
Purpose: Although delayed-enhancement magnetic resonance imaging (DEMRI) is essential for diagnosis of cardiac sarcoidosis (CS), the test was not available when pacemaker was implamted. Recently, MR-conditional pacemaker has become avilable and we hypothesized that this device would be useful for diagnosis and management of CS. The aim of this study was to assess the diagnostic ability of MR-conditional pacemaker about CS in patients with advanced A-V nodal block (AAVB). Methods: Twenty-seven AAVB patients (14 men, 13 women; mean age, 69 ± 11 years) who were implanted MR-conditional pacemaker were studied. DEMRI was performed 6 weeks after implantation of permanent pacemaker. In patients with positive for DE, additional examinations like echocardiography, radioisotope imaging, biopsy, and coronary computed-tomography were performed due to confirm the diagnosis of CS and exclude coronary artery disease. Results: DE was observed in 12 patients (44 %). Out of 12 patients, 2 patients were excluded for having prior myocardial infarction. Seven of 10 (70 %) patients were diagnosed of CS by the consensus criteria. Compared with non-CS group, CS group had significantly lower age (61 ± 12 years vs. 72 ± 9 years p = 0.017). There was no significant difference about sex, angiotensin-converting enzyme, brain natriuretic peptide, and left ventricular ejection fraction between 2 groups. Six patients had started corticosteroid therapy and 5 patients (83%) recovered A-V nodal conduction. Conclusion: MR-conditional pacemaker was useful for diagnosis and management of patients with AAVB caused by CS. Figure
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Abstract
Introduction: The relationship between the appropriateness of the transthoracic echocardiography (TTE) and its clinical impact is still a matter of debate. Objective: The aim of this study was to assess the degree of adherence to the appropriate use criteria for echocardiography, in a tertiary public hospital in the United Kingdom, as well as the clinical impact of the exam on patient management. Methods: 859 TTE’s performed consecutively during January 2014 were reviewed to assess its appropriateness, and were classified as appropriate, uncertain or inappropriate using the 2011 guidelines. Subsequently, patient’s files were examined to determine the clinical impact of the TTE which was assigned to one of the following three categories: (1) active change in care, (2) continuation of current care, or (3) no change in care. Patients which files were not available were excluded (259). All classifications were evaluated by two independent cardiologists, with no direct relation to the study. Results: Our sample had a mean age of 63 ± 17 years with a gender balance. The majority of the exams were requested at the outpatient (81.4%) clinic, by cardiologists (50.3%) and general practitioners (13.4%). Regarding the main findings, in 7.6% of the studies there were moderate to severe systolic dysfunction; 4.0% showed severe valvular heart disease and 5.1% had significant pulmonary hypertension. Relatively to the appropriateness of the TTE requests, 76.5% were considered appropriate, 7.1% inappropriate and 12.6% uncertain. With respect to the clinical impact of the TTE’s, 42.7% of the exams led to an active change in care, 15.6% to a continuation of the care and 11.5% revealed no change in care. Age (β0.90, P=0.05) and outpatient setting (β4.4, P<0.01) were the most important predictors of an active change of care exam. On the contrary, the appropriateness of the TTE’s requests (β1.1, P=0.56) and the specialist ordering the exams (β0.81, P=0.26) were not independently associated. Conclusion: Our data showed that almost 8 out of 10 TTE were considered appropriate, and 4 out of 10 exams had an active clinical impact.
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Zalen, JJ, Sugihara, C, Patel, NR, Sulke, AN, Lloyd, GW, Kochanowski, J, Piatkowski, R, Scislo, P, Grabowski, M, Marchel, M, Opolski, G, Goebel, B, Roland, H, Hamadanchi, A, Otto, S, Jung, C, Lauten, A, Figulla, HC, Poerner, TC, Ladeiras-Lopes, R, Sampaio, F, Fonseca, P, Fontes-Carvalho, R, Pinho, M, Campos, AS, Castro, P, Fonseca, C, Ribeiro, J, Gama, V, Goebel, B, Heck, R, Hamdanchi, A, Otto, S, Jung, C, Lauten, A, Figulla, HR, Poerner, TC, Karvandi, M, Ranjbar, S, Ghaffaripour Jahromi, M, Karvandi, M, Ranjbar, S, Alonso Salinas, G, Hinojar, R, Fernandez Golfin, C, Esteban, A, Pascual-Izco, M, Garcia-Martin, A, Casas Rojo, E, Jimenez-Nacher, JJ, Zamorano, JL, Unkun, T, Gecmen, C, Cap, M, Izci, S, Erdogan, E, Onal, C, Acar, R, Bakal, RB, Kaymaz, C, Ozdemir, N, Ranjbar, S, Karvandi, M, Ghaffaripour Jahromi, M, Hubert, A, Galand, V, Schnell, F, Matelot, D, Martins, R, Leclercq, C, Carre, F, Enescu, OA, Suran, BC, Margulescu, AD, Rimbas, RC, Siliste, C, Vinereanu, D, Liccardo, M, Nocerino, P, Urso, AC, Borrino, A, Carbone, C, Follero, P, Ciardiello, C, Prato, L, Salzano, G, Cameli, M, Marino, F, Ruspetti, A, Sparla, S, Di Tommaso, C, Loiacono, F, Focardi, M, D'ascenzi, F, Henein, M, Mondillo, S, Ako, E, Porter, J, Walker, M, Lembo, M, Lo Iudice, F, Esposito, R, Santoro, C, Cocozza, S, Izzo, R, De Luca, N, De Simone, G, Trimarco, B, Galderisi, M, Goffredo, C, Gervasi, F, Patti, G, Mega, S, Bono, M, Di Sciascio, G, Enache, R, Buture, A, Badea, R, Platon, P, Ghiorghiu, I, Jurcut, R, Coman, IM, Popescu, BA, Ginghina, C, Novo, G, Lunetta, M, Spoto, MS, Lo Vi, AM, Pensabene, G, Meschisi, MC, Carita, P, Coppola, G, Novo, S, Assennato, P, Wdowiak-Okrojek, K, Shim, A, Wejner-Mik, P, Kasprzak, JD, Lipiec, P, Nemes, A, Havasi, K, Domsik, P, Kalapos, A, Forster, T, Nemes, A, Piros, GA, Domsik, P, Kalapos, A, Lengyel, C, Orosz, A, Forster, T, Di Salvo, G, Bulbul, Z, Issa, Z, Al Sehly, A, Pergola, V, Oufi, S, Capotosto, L, Conde, Y, Cimino, E, Rinaldi, E, Ashurov, R, Ricci, S, Pergolini, M, Vitarelli, A, Caravaca, P, Lujan Valencia, JE, Chaparro, M, Garcia-Guerrero, A, Cristo Ropero, MJ, Izquierdo Bajo, A, Madrona, L, Recio-Mayoral, A, Maceira Gonzalez, A M, Monmeneu, JV, Igual, B, Lopez Lereu, P, Garcia, MP, Iriart, X, Selmi, W, Jalal, Z, Thambo, JB, Jug, B, Kosuta, D, and Fras, Z
Abstract
Background: Handheld ultrasound devices allow for a bedside screening although quantitative parameters are not easily obtained. We aim to assess the reliability of visual qualitative evaluation of left ventricle (LV) compared with standard quantitative evaluation with 2D transthoracic echocardiography (TTE). Methods: Two cardiologists have reviewed 135 consecutive standard TTE examinations. Both observers visually assessed LV size, hypertrophy (LVH) and ejection fraction (EF). LV diameter, volume, wall thickness and EF (Teichholz and Simpson) were also measured by both observers. Visual and quantitative agreement and inter and intraobserver variability were calculated. Results: Image quality allowed for evaluation of 130 examinations. Visually assessed EF compared with Simpson had better consistency (Intraclass correlation coefficient [ICC] 0,91 IC95% 0,88-0,94) than with Teichholz (ICC 0,75 IC95% 0,66-0,82). We have also observed good interobserver agreement regarding visually assessed EF (ICC 0,81 IC95% 0,71-0,87) and Simpson EF (ICC 0,80 IC95% 0,70-0,89) as well as good intraobserver agreement (visual EF: ICC 0,81 IC95% 0,74-0,86; Simpson: ICC 0,89 IC95% 0,84-0,93). Regarding LVH we found moderate agreement between visual and quantitative assessment (weighted Kappa [wK] 0,44 (IC95% 0,32-0,56)), moderate interobserver agreement for quantitative assessment (ICC 0,59 IC95% 0,44-0,71) and poor interobserver agreement for visual assessment (wK 0,19 IC95% 0,08-0,30). Intraobserver variability regarding LVH visual estimation was moderate (wK 0,40 IC95% 0,29-0,52) and regarding LVH quantification was good (ICC 0,78 IC95% 0,70-0,84). LVH was visually overestimated in 25% of examinations. Regarding LV size, we found poor agreement between visual assessment and its quantification with end-diastolic diameter (wK 0,22 IC95% 0,06-0,39) and moderate agreement between visual assessment and end-systolic LV volume (wK 0,62 IC95% 0,47-0,77). Interobserver agreement regarding quantitative volume assessment was good (ICC 0,90 IC95% 0,85-0,94) and regarding visual assessment was moderate (wK 0,43 IC95% 0,26-0,70). We found good intraobserver variability of volume measurement (wK 0,64 IC95% 0,50-0,78) and of visual size assessment (ICC 0,96 IC95% 0,94-0,97). Conclusions: Visual LVEF assessment is consistent with quantitative assessment and should be regarded as a reliable parameter that can be obtained from bedside examination with a handheld device. Visual assessment of LV size and wall thickness is less reliable than its quantification and should be confirmed with standard measurements.
Pontone, G, Andreini, D, Annoni, A, Petulla, M, Russo, E, Innocenti, E, Guglielmo, M, Mushtaq, S, Tondo, C, Pepi, M, Demir, OM, Bashir, A, Marshall, K, Douglas, M, Wasan, B, Plein, S, Alfakih, K, Celeng, C, Kolossvary, M, Kovacs, A, Szilveszter, B, Molnar, A, Horvath, T, Jermendy, AL, Tarnoki, AD, Merkely, B, Maurovich-Horvat, P, Llao-Ferrando, JI, Castro, JC, Vilades-Medel, D, Mirabet, S, Pons-Llado, G, Roig, E, Leta, R, Kitsiou, A N, Papanikolaou, S, Griroriou, K, Antonopoulos, M, Mpouki, M, Moustakas, G, Giougi, A, Giannakopoulos, V, Gionakis, G, Balomenos, A, Portugal, G, Abreu, A, Rio, P, Santos, V, Martins Oliveira, M, Silva Cunha, P, Mota Carmo, M, Branco, L M, Morais, L, Cruz Ferreira, R, Becoulet, L, Guijarro, D, Pallardy, A, Mathieu, C, Valette, F, Gueffet, JP, Serfaty, JM, Kraeber-Bodere, F, Trochu, JN, Piriou, N, Demir, OM, Bashir, A, Marshall, K, Wasan, B, Plein, S, Alfakih, K, Marcos-Alberca Moreno, P, Perez-Isla, L, Palacios, J, Gomez De Diego, JJ, Islas, F, De Agustin, JA, Luaces, M, Arrazola, J, Garcia-Fernandez, MA, Macaya, C, Iriart, X, Selmi, W, Jalal, Z, and Thambo, JB
Abstract
Background: The outcome of radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF) has improved thanks to left atrium (LA) anatomy reconstruction by computed tomography with adaptive statistical iterative reconstruction algorithm (CT-ASIR) before the procedure. However, CT-ASIR strategy is associated to an increase of cumulative effective radiation dose (ED) in these patients. Recently, a model-based iterative reconstruction algorithm (MBIR, GE Healthcare, Waukesha,Wisconsin) has been developed (CT-MBIR) for image noise reduction reducing the ED close to chest X-ray exposure. The aim of this study is to compare the CT and RFCA characteristics, AF recurrence after procedure and radiation exposure between RFCA guided by image integration with CT-ASIR versus CT-MBIR Methods and Materials: One-hundred twenty consecutive patients with drug-refractory paroxysmal or persistent AF were addressed to CT-ASIR (Group 1; N: 60; mean age 60.3 ± 10.1 yo; male: 46) or CT-MBIR protocol (Group 2; N: 60; mean age 59.7 ± 11.3 yo; male:45) for evaluation of LA before RFCA. All patients were subsequently treated by image integration-supported RFCA. Image noise, signal to noise ratio (SNR), contrast to noise ratio (CNR), RFCA procedural characteristics, rate of AF recurrence and CT radiation exposure were measured and compared between the two groups. Results: The two groups were homogeneous in terms of demographic characteristics, cardiovascular risk factors, prevalence of persistent AF, medical therapy and echocardiographic characteristics. The mean follow-up was similar (578 ± 284 vs. 591 ± 278 days, respectively, p:ns). Group 2 showed a higher signal to noise ratio (25.9 ± 7.1 vs. 13.8 ± 5.1) and contrast to noise ratio (22.7 ± 6.5 vs. and 14.08 ± 4.1) of left atrium as compared to Group 1 (p<0.001). No differences were found in terms of RFCA parameter [procedural duration (130.9 ± 130.6. vs. 143.8 ± 80.4 min); fluoroscopy time (27.9 ± 14.1.0 vs. 32.0 ± 16.4 min); pulmonary veins isolated (3.8 ± 0.4 vs. 3.9 ± 0.4)] and the rate of AF recurrence (31% vs. 29%) between Group 2 vs Group 1. Group 2 showed a 94% reduction of ED as compared to Group 1 (0.4 ± 0.04 mSv vs 6.4 ± 1.8 mSv, p<0.01). Conclusions: CT-MBIR allows accurate non-invasive reconstruction of LA anatomy in AF patients undergoing to RFCA with a submillisievert effective radiation and comparable success rate of RFCA with CT-ASIR technique.
Turco, A, Duchenne, J, Nuyts, J, Gheysens, O, Voigt, J-U, Claus, P, Vunckx, K, Muhtarov, K, Ozer, N, Turk, G, Sunman, H, Karakulak, U, Sahiner, L, Kaya, B, Yorgun, H, Hazirolan, T, Aytemir, K, Warita, S, Kawasaki, M, Tanaka, R, Houle, H, Yagasaki, H, Nagaya, M, Ono, K, Noda, T, Watanabe, S, Minatoguchi, S, Kyle, AS, Dauphin, C, Lusson, J R, Dragoi Galrinho, R, Rimbas, RC, Ciobanu, AO, Marinescu, B, Cinteza, M, Vinereanu, D, 28343/04.11.2013, number, Medicine, Funding Authority: University of, Davila, Pharmacy Carol, "Young Researchers" Projects – 2013, Buchar, Dragoi Galrinho, R, Ciobanu, AO, Rimbas, RC, Marinescu, B, Cinteza, M, Vinereanu, D, 159/1.5/S/138907, Grant POSDRU, Aparina, O, Stukalova, O, Butorova, E, Makeev, M, Bolotova, M, Parkhomenko, D, Golitsyn, SP, Zengin, E, Hoffmann, B A, Ramuschkat, M, Ojeda, F, Weiss, C, Willems, S, Blankenberg, S, Schnabel, R B, Sinning, C R, Schubert, U, Suhai, F I, Toth, A, Kecskes, K, Czimbalmos, CS, Csecs, I, Maurovich-Horvat, P, Simor, T, 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Bruckner, I, Plaskota, KJ, Trojnarska, O, Bartczak, A, Grajek, S, Sharma, P, Sharma, D, Garg, S, Vazquez Lopez-Ibor, J, Monivas Palomero, V, Solano-Lopez, JM, Zegri Reiriz, I, Dominguez Rodriguez, F, Gonzalez Mirelis, J, Mingo Santos, S, Sayago, I, Garcia Pavia, P, Segovia Cubero, J, Konecny, T, Noseworthy, P, Kapa, S, Cooper, LT, Mulpuru, SK, Asirvatham, S, Florescu, M, Mihalcea, D, Magda, S, Radu, E, Chirca, A, Acasandrei, AM, Jinga, D, Mincu, R, Enescu, OA, Vinereanu, D, 112/2011, no., PN-II-ID-PCE-2011-3-0791, Saura Espin, D, Caballero Jimenez, L, Oliva Sandoval, MJ, Gonzalez Carrillo, J, Garcia Navarro, M, Espinosa Garcia, MD, Valdes Chavarri, M, De La Morena Valenzuela, G, Abul Fadl, AAM, Mourad, MM, team, Primary care Echocardiography, Campanale, C M, Di Maria, S, Mega, S, Nusca, A, Marullo, F, Di Sciascio, G, Pardo Gonzalez, L, Delgado, M, Ruiz, M, Rodriguez, S, Hidalgo, F, Ortega, R, Mesa, D, Suarez De Lezo Cruz Conde, J, Bengrid, T M, Zhao, Y, Henein, MY, Kenjaev, S, Alavi, AL, Kenjaev, ML, Mendes, LM, Lima, S, Dantas, C, Melo, I, Madeira, V, Balao, S, Alves, H, Baptista, E, Mendes, P, Santos, JF, Scali, MC, Mandoli, GE, Simioniuc, A, Massaro, F, Di Bello, V, Marzilli, M, Dini, FL, Cifra, B, Dragulescu, A, Friedberg, MK, Mertens, L, Scali, MC, Bayramoglu, A, Tasolar, H, Otlu, YO, Hidayet, S, Kurt, F, Dogan, A, Pekdemir, H, Stefani, L, Galanti, GG, De Luca, ADL, Toncelli, LT, Pedrizzetti, GP, Gopal, A S, Saha, SK, Toole, RS, Kiotsekoglou, A, Cao, JJ, Reichek, N, Ho, S-J, Hung, S-C, Chang, F-Y, Liao, J-N, Niu, D-M, Yu, W-C, Nemes, A, Kalapos, A, Domsik, P, Forster, T, Siarkos, M, Sammut, E, Lee, L, Jackson, T, Carr-White, G, Rajani, R, Kapetanakis, S, Jarvinen, VM, Sipola, P, Madeo, A, Piras, P, Evangelista, A, Giura, G, Dominici, T, Nardinocchi, P, Varano, V, Chialastri, C, Puddu, PE, Torromeo, C, Sanchis Ruiz, L, Montserrat, S, Obach, V, Cervera, A, Bijnens, B, Sitges, M, Charisopoulou, D, Banner, N R, Rahman-Haley, S, Kim, BJ, Kang, JG, Lee, SH, Sung, KC, Kim, BS, Kang, JH, Lee, ES, Imperadore, F, Del Greco, M, Jermendy, AL, Horcsik, DV, Horvath, T, Celeng, C, Nagy, E, Bartykowszki, A, Tarnoki, DL, Merkely, B, Maurovich-Horvat, P, Jermendy, G, Whitaker, J, Demir, OM, Walton, J, Wragg, A, Alfakih, K, Karolyi, M, Szilveszter, B, Raaijmakers, R, Giepmans, W, Horvath, T, Merkely, B, Maurovich-Horvat, P, Koulaouzidis, GK, Charisopoulou, DC, Mcarthur, TM, Jenkins, PJJ, Henein, MH, Silva, T, Ramos, R, Oliveira, M, Marques, H, Cunha, P, Silva, MN, Barbosa, C, Sofia, A, Pimenta, R, Ferreira, RC, Al-Mallah, M, and Alsaileek, A
Abstract
Clinical PET acquisitions of the heart suffer from artefacts and drops in image quality due to the poor spatial resolution of the PET system. Moreover, cardiac PET images are further degraded by the blur caused by the breathing and beating motions, thus hampering diagnosis and evaluation of myocardial pathologies. Anatomy-enhanced PET reconstruction, using a high-resolution CT, has proven useful in brain imaging. In cardiac datasets however, due to the motion artefacts, the application of any restoring technique on datasets affected by motion blur needs to be preceded by the validation of the proposed method on realistic static datasets. In this work, the validation is performed using static cardiac ex vivo datasets obtained from a number of sacrificed sheep, scanned on a clinical PET/CT scanner. The aim of this work is to assess the effectiveness of reconstructions of the acquired datasets with different CT-based anatomical priors, in comparison to reconstructions currently applied in clinical practise. The gold standard to which all reconstructions are compared consists of images of the same hearts scanned on a small-animal PET scanner, whose high spatial resolution allows for almost artefact-free images. Encouraging results were obtained so far, with improvements in volume delineation and uniformity of activity values when anatomical information was used. Fig 1 shows the gold standard image (left) compared to a regular clinical reconstruction (middle) and to a reconstruction using the high-resolution CT as anatomical information (right). Figure
Guglielmo, M, Cefalu', C, Savioli, G, Mirea, O, Fusini, L, Scali, MC, Simioniuc, A, Dini, F, Barbier, P, Hasselberg, NE, Haugaa, KH, Bernard-Brunet, A, Kongsgaard, E, Donal, E, Edvardsen, T, Mada, RO, Lysyansky, P, Winter, S, Fehske, W, Stankovic, I, Voigt, JU, Domingos, JS, Boardman, H, Leeson, P, Noble, JA, Kou, S, Caballero, L, Henri, C, Dulgheru, R, Magne, J, Daimon, M, Watanabe, H, Ito, H, Yoshikawa, J, Lancellotti, P, Brunet Bernard, A, Donal, E, Leclercq, C, Schnell, F, Fournet, M, Reynaud, A, Thebault, C, Mabo, P, Daubert, JC, Hernandez, A, Park, J, Naksuk, N, Thongprayoon, C, Gaba, P, Sharma, S, Rosenbaum, A, Hu, T, Kapa, S, Bruce, C, Asirvatham, S, Kosmala, W, Rojek, A, Karolko, B, Mysiak, A, and Przewlocka-Kosmala, M
Abstract
Purpose. We previously re-validated noninvasive estimation of pulmonary wedge pressure (PWP) measuring the CW pulmonary valve regurgitation end-diastolic pressure gradient (PWPecho). Using the latter as surrogate of PWP, we sought to test accuracy of left ventricular (LV) filling pressures estimation by the EAE guidelines algorithm (EAEalg) in a large non-selected population. Methods. We studied 1019 patients in sinus rhythm with GE Vivid7/9 systems (age: 10-93 y.; EF%: 13-83%, normal, n= 827 and reduced <50%, n= 192), in whom PWPecho could be measured (feasibility 75%), with normal pulmonary vascular resistances (WU< 2). The EAEalg combined E/e' (average), left atrial volume (LAV), E/A, Edec, pulmonary venous systolic fraction (SF), and echo-derived pulmonary systolic pressure (PSPe) to obtain 3 groups: normal, high PWP and not classifiable. These were compared to the PWPecho estimate. Results: Feasibility was high for all variables (E/E' 90%, LAV 93%, E/A 95%, Edec 90%, SF 91%, PSPe 92%), and for the EAEAlg (94%). Using the EAEAlg, 17% (n=137) of patients with normal in contrast to 10% (n=19) of patients with EF<50% were not classifiable, in the former secondary to the combination of a E/E'= 9-13 range, and LAV≥ 34ml/m2. In the remaining (classified, 84%) patients, utility of EAEalg even when limited to patients with EF<50% was still hampered by a low positive predictive value (PPV) (Table). Further, when only E/e' was tested in the same patients at ROC analysis (cutoff= 15; AUC=0.72, CI:0.6-0.8), accuracy was still impaired by a low PPV (53%), albeit a fair negative predictive value (NPV) (79%). Correlation between PWPecho and E/e' was modest even in patients with EF<50% (r=0.4, p<0.001), and at multiple regression analysis, E/e' was independently determined by age and mitral regurgitation in all patients, and by LV end-diastolic volume in EF<50% (r= 0.7, p<0.001) and by LV mass index in EF>50% (r= 0.64, p<.001). Conclusions. Noninvasive estimation of PWP by EAE guidelines is limited by a low PPV in both patients with and without reduced LV EF. In this setting, utility of the E/e' is limited, it being influenced by patient age, preload and LV mass.
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C, Crea, P, Cusma Piccione, M, Vriz, O, Bitto, A, Minisini, R, Madaffari, A, Acri, E, Oteri, A, Carerj, S, Leggio, S, Buccheri, S, Tamburino, C, Monte, I P, Mihalcea, D, Florescu, M, Enescu, OA, Magda, LS, Radu, E, Acasandrei, AM, Balanescu, P, Rimbas, RC, Jinga, D, Vinereanu, D, 112/2011, Research grant, Miyoshi, T, Tanaka, H, Kaneko, A, Matsumoto, K, Imanishi, J, Motoji, Y, Mochizuki, Y, Minami, H, Kawai, H, Hirata, K, Ryu, SK, Shin, DG, Son, JW, Choi, JH, Goh, CW, Choi, JW, Park, JY, Hong, GR, Le Page, P, Mitchell, ARJ, Maclachlan, HI, Hurry, RW, Villagraz Tecedor, L, Jimenez Lopez Guarch, C, Alonso Chaterina, S, Mayordomo Gomez, S, Blazquez Arrollo, L, Lombera Romero, F, Lopez Melgar, B, Escribano Subias, MP, Lichodziejewska, B, Kurnicka, K, Goliszek, S, Kostrubiec, M, Dzikowska Diduch, O, Krupa, M, Grudzka, K, Ciurzynski, M, Palczewski, P, Pruszczyk, P, Lovric, D, Carmona, C, Bergerot, C, Schnell, F, Thibault, H, Barthelet, M, Ninet, J, Revel, D, Croisille, P, Derumeaux, G, 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Abstract
Pulmonary vascular dysfunction is claimed to be a contributor to the development of pulmonary hypertension (PH). Impaired systemic vascular reactivity is one of the essential factors in the pathogenesis of cardiovascular disease. The aim of the investigation was to study whether there is any association between systemic vascular function and pulmonary artery pressure (PAP) in patients who have associated causes for PH development, such as coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD). Methods: The brachial artery vasodilator responses were measured by the ultrasound technique in twenty patients with mild to moderate COPD (group I) and twenty age–matched and COPD stage-matched patients who had past history of myocardial infarction (NYHA II) (group II).Conventional echocardiographic variables were measured in the said patients too. Results: Both flow-mediated dilatation (FMD) and nitrate-mediated dilatation (NMD) were significantly lower, and PAP was significantly higher in the group II patients compared to the same parameters of group I patients. NMD was inversely correlated with PAP (r=-0.7, p=0.02) in group I patients. There was no interrelation between FMD and PAP in patients from group I. Neither FMD nor NMD were correlated with PAP in group II patients. A significant positive correlation between PAP and left ventricular mass index (r=0.8, p=0.003) was revealed in the said patients as well. Conclusions: Attenuated vasodilator response of brachial artery to nitroglycerine is associated with PAP elevation in COPD patients. PH is closely related to cardiac remodeling in COPD patients in whom CHD developed. These data suggest different "stages" of vascular and cardiac remodeling in patients with COPD alone and in coexistence with CHD. The obtained data can be useful in the selection of treatment as regards these patient categories.
Weinberg, J. Brice, DiLillo, David J., Iwata, Yohei, Matushita, Takashi, Matta, Karen M., Venturi, Guglielmo M., Russo, Giandomenico, Chen, Youwei, Gockerman, Jon P., Moore, Joseph O., Diehl, Louis F., Volkheimer, Alicia D., Friedman, Daphne R., Lanasa, Mark C, Hall, Russell P., and Tedder, Thomas J.
Abstract
The cell of origin of CLL is unknown. Researchers have proposed various B cell subsets as the normal counterparts based on surface marker similarities or Ig gene utilization comparisons of normal and CLL cells. Regulatory B lymphocytes (“B10” cells), with the capacity to produce IL-10, negatively regulate T cell, B cell, and mononuclear phagocyte function. CLL patients are immunosuppressed with abnormalities in both humoral and cellular immunity. B10 cells have a phenotype similar to CLL cells (CD24hiCD27+CD5+CD19+). B10 cells are increased in autoimmune mice and in humans with autoimmune diseases—situations in which these cells negatively regulate immune-mediated inflammation. Since CLL cells and B10 cells may share common phenotypes and immunosuppressive mechanisms, we sought to determine if mouse and human CLL cells share common cellular origins and regulatory properties.Mouse spleen, lymph node, and bone marrow cell, and human blood B lymphocyte and CLL cell preparation and culture; IL-10, TNF, IGHV determinations; and flow cytometry were done as we have reported before (Blood 109:1559, 2007; Blood 117:530–541, 2010; Immunity 28:639–650, 2008). After culture for 5 hours with LPS and PMA+ionomycin+brefeldin A (PIB), or CpG+PIB, we assessed for intracellular IL-10 by flow cytometry. We term these IL-10 producing cells “B10” cells. Alternately, cells were cultured 48 hours with CD40 ligand+LPS or CD40L+CpG, and then PIB was added during the last 5 hours, after which cells were assessed for intracellular IL-10. We term these IL-10 positive cells “B10+B10pro” cells.We examined CLL cells from 54 CLL patients. Most had low-risk disease: 90% were either Rai stage 0 or stage 1, 89% were CD38 negative, 46% were Zap70 negative, and 70% had a mutated IGHV. Twenty percent had normal cytogenetics, 48% del13q, 20% trisomy 12, 4% del17p, 4% del11q, and 4% with complex abnormalites. Patients with CLL as compared to healthy controls had higher numbers of B10pro cells compared to those of normal controls (7.7±0.9% and 3.2±0.3%, respectively; p<0.0001). CLL cells had a CD24hiCD27+ memory B cell phenotype similar to normal human B10 cells, and CLL cells secreted IL-10 when treated in vitro with CpG or CD40L/CpG, as do normal human B10 cells. CLL cell TCL-1 protein levels (immunoblot) correlated directly with CLL B10pro percentages (p=0.001) and absolute numbers (p=0.01). CLL patients' plasma IL-10 levels were 1.5 fold higher than those of age-matched healthy controls (p=0.008), and these levels correlated directly with the absolute numbers of CLL cells that were competent to produce IL-10 after 48 hours stimulation with CD40L/CpG.To validate the precursor/product relationship between B10 cells and CLL, we studied the TCL-1 transgenic mouse model of CLL. TCL-1 transgenic mice had an age-dependent expansion of splenic CD5+B220int cells, and these leukemic cells were IL-10-competent. Likewise, aged TCL-1 mice had increased numbers of B10 cells in the bone marrow, lymph nodes, and peritoneal cavity. The TCL-1 CLL cells were similar in phenotype (IgM+CD11BhiCD23lowCD43hiCD19+) to mouse regulatory B10 cells (CD1dhiIgMhiIgDlowCD19hiCD23lowCD24hiCD43±) that we have previously reported. TCL-1 CLL cells produced IL-10 in vitro and in vivo, and depressed mouse macrophage TNF production. This TCL-1 CLL cell-mediated inhibition of mouse TNF production was blocked by anti-IL-10 antibody. Plasma IL-10 increased with age and with development of overt leukemia in TCL-1 mice.We demonstrate for the first time that human CLL cells and CLL-like cells from TCL-1 mice share a common origin with regulatory B10 and B10pro cells. Both CLL cells and B10 cells can produce the immuno-inhibitory cytokine IL-10 in vitro and in vivo, and they can suppress mononuclear phagocyte activation in vitro through IL-10-dependent pathways. The immunophenotype of CLL cells matches that of human B10, and B10pro cells. It is likely that IL-10 competent CLL cells derive directly from either regulatory B10pro or B10 cells. B10 cell-derived IL-10 may contribute to the immunosuppression noted in mice and humans with CLL. Future studies may lead to new and better treatments that take advantage of links between B10 cells, IL-10, and CLL.Lanasa: GlaxoSmithKline: Consultancy, Speakers Bureau. Tedder:Angelica: Consultancy, Share holder; Takeda Therapeutics: Consultancy.
A recent study conducted by researchers from the National Institute of Allergy and Infectious Diseases (NIAID) explores the impact of maternal immunity on HIV-exposed uninfected (HEU) infants. The study found that HEU infants exhibit elevated pro-inflammatory biomarkers that persist after birth. The researchers analyzed paired plasma samples from 46 HEU infants and their mothers and compared them to pregnant women without HIV and their unexposed uninfected newborns. The results showed that HEU infants had elevated biomarkers associated with germinal centers, macrophage activation, and interferon gamma (IFN-g)-inducible chemokines, as well as elevated anti-inflammatory cytokines. However, by 6 months, many of these biomarkers normalized to levels similar to unexposed uninfected infants, indicating a transient inflammatory effect. [Extracted from the article]
Guimarães, David Bernar Oliveira, Rodrigues, Tatyanne Silva, Oliveira, Sarah Carolline Mazza, and Avelino, Fernanda Valéria Silva Dantas
Subjects
ANGINA pectoris, ELECTROCARDIOGRAPHY, NURSING care facilities, EMERGENCY nursing, MYOCARDIAL infarction, DATA analysis, PATIENTS
Abstract
Copyright of Words Without Borders: The Online Magazine for International Literature is the property of Words Without Borders and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
CARDIAC amyloidosis, COMPUTED tomography, AMYLOIDOSIS, CLINICAL decision support systems, PROGNOSIS
Abstract
Keywords: Amyloidosis; Cardiology; Computed Tomography; Health and Medicine; Imaging Technology; Metabolic Diseases and Conditions; Nephrology; Nutritional and Metabolic Diseases and Conditions; Proteostasis Deficiencies; Technology EN Amyloidosis Cardiology Computed Tomography Health and Medicine Imaging Technology Metabolic Diseases and Conditions Nephrology Nutritional and Metabolic Diseases and Conditions Proteostasis Deficiencies Technology 756 756 1 07/03/23 20230707 NES 230707 2023 JUL 3 (NewsRx) -- By a News Reporter-Staff News Editor at Medical Imaging Week -- New study results on amyloidosis have been published. Amyloidosis, Cardiology, Computed Tomography, Health and Medicine, Imaging Technology, Metabolic Diseases and Conditions, Nephrology, Nutritional and Metabolic Diseases and Conditions, Proteostasis Deficiencies, Technology. [Extracted from the article]
We report on a trapped atom interferometer based on Bragg diffraction and Bloch oscillations with alkaline-earth-metal atoms. We use a Ramsey-Bordé Bragg interferometer with 88Sr atoms combined with Bloch oscillations to extend the interferometer time. Thanks to a long coherence time for Bloch oscillations of 88Sr atoms, we observed interference up to 1 s evolution time in the lattice. A detailed study of decoherence sources during the Bloch phase is also presented. While still limited in sensitivity by lattice lifetime and beam inhomogeneity this result opens the way to high contrast trapped interferometers with extended interrogation time. [ABSTRACT FROM AUTHOR]
Gonzalez-Mercado, Velda J., Marrero, Sara, Marrero-Falcon, Miguel A., and Saligan, Leorey N.
Subjects
Depression (Mood disorder) -- Care and treatment, Sleep -- Analysis, Cancer research -- Analysis, Patient compliance -- Analysis, Radiotherapy -- Analysis, Fatigue -- Care and treatment, Prostate cancer -- Care and treatment, Sleep disorders -- Care and treatment, Health, Health care industry
Abstract
Multivariate analyses showed sleep disturbance and depression were significant factors associated with and increased risk for fatigue during radiotherapy for prostate cancer. It is plausible that identifying and managing sleep disturbance and depression may prevent and ameliorate fatigue. Key Words Prostate cancer, radiotherapy, fatigue, sleep disturbance, depression, Puerto Ricans., Prostate cancer (PC) is a curable disease, but it is still one of the most prevalent malignancies worldwide. In the United States and its territories (including Puerto Rico), the incidence [...]
Byline: M. N. Rajpar, M. Zakaria, I. Ozdemir, S. Sheryar and A. RabABSTRACTBirds are the most conspicuous component of wetland habitats, i.e., they are highly motile and sensitive to multitude [...]
Medical research -- Analysis, Proteins -- Research -- Analysis, Health
Abstract
2017 JUN 10 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- Current study results on Nutritional and Metabolic Diseases and Conditions - Obesity [...]
Banking, finance and accounting industries, Business, Business, international
Abstract
Previous studies find that the interest rate term spread predicts real U.S. economic activity. We show that this relationship breaks down for the 1990s and suggest that its earlier success was due to high and volatile inflation. We find, however, that the high-yield spread (HYS) between 'junk bond' and government bond yields predicts real activity during the 1990s--especially high levels of the HYS. We also find that the HYS works through both the demand and the supply side of the economy. We interpret our findings as supportive of a financial accelerator mechanism. [JEL E33, E44], The slope of nominal yield curve, or the term spread, was shown by studies published in the late 1980s and early 1990s to have significant predictive content for future real [...]
Obesity -- Care and treatment, Body weight, Angiography, CT imaging, Contrast media -- Evaluation, Physical fitness, Health, University of Milan -- Evaluation
Abstract
2016 NOV 12 (NewsRx) -- By a News Reporter-Staff News Editor at Obesity, Fitness & Wellness Week -- New research on Halogens is the subject of a report. According to [...]