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The COVID-19 pandemic has presented an unprecedented challenge to public health and other community level systems throughout the United States since 2020. Investigating county-level factors (covariates in a statistical sense) closely related to COVID mortality is an important research objective, as it can provide insight for improving pandemic preparedness and response. Community resilience, which signifies the capability and capacity of communities to withstand and recover from adverse events, is a crucial component of pandemic preparedness. In this study, researchers employed Pearson's correlation coefficient and mediation analysis to explore the community resilience predicted by the Composite of Post-Event Well-Being (COPEWELL) model as a potential covariate that could be used to predict COVID-19 fatalities and further examine the generalizability and validity of the COPEWELL Model to the pandemic. Our findings indicate that the resilience predicted by the COPEWELL model is more strongly associated with COVID-19 health oucomes than county-level vaccination rates, although vaccination rate partially mediates the relationship between community resilience and COVID-19 fatalities per capita. This article underscores the effectiveness of implementing comprehensive all-hazards preparation strategies in the context of a pandemic and demonstrates that the COPEWELL model can serve as a valuable tool for identifying investments that can enhance community resilience. [ABSTRACT FROM AUTHOR]

Radiation exposure to the thyroid gland during treatment of childhood, adolescent and young adult cancer (CAYAC) may cause differentiated thyroid cancer (DTC). Surveillance recommendations for DTC vary considerably, causing uncertainty about optimum screening practices. The International Late Effects of Childhood Cancer Guideline Harmonization Group, in collaboration with the PanCareSurFup Consortium, developed consensus recommendations for thyroid cancer surveillance in CAYAC survivors. These recommendations were developed by an international multidisciplinary panel that included 33 experts in relevant medical specialties who used a consistent and transparent process. Recommendations were graded according to the strength of underlying evidence and potential benefit gained by early detection and appropriate management. Of the two available surveillance strategies, thyroid ultrasound and neck palpation, neither was shown to be superior. Consequently, a decision aid was formulated to guide the health care provider in counseling the survivor. The recommendations highlight the need for shared decision making regarding whether to undergo surveillance for DTC and in the choice of surveillance modality. [ABSTRACT FROM AUTHOR]

Background Cholesterol, required for adrenal steroid hormone synthesis, is at least in part derived from circulating lipoproteins. The contribution of high-density lipoproteins (HDL) and low-density lipoproteins (LDL) to adrenal steroidogenesis in humans is unclear. Objective The aim of the study was to determine the extent to which HDL and LDL are taken up by the adrenal glands using samples obtained during adrenal venous sampling (AVS). Methods AVS was successfully performed in 23 patients with primary aldosteronism. Samples were drawn from both adrenal veins and inferior vena cava (IVC). HDL cholesterol (HDL-C) and lipoprotein particle profiles were determined by nuclear magnetic resonance spectroscopy. Apolipoprotein (apo) A-I and apoB were assayed by immunoturbidimetry. Results Plasma HDL-C and HDL and LDL particle concentrations (HDL-P and LDL-P) were not lower in samples obtained from the adrenal veins compared with the IVC (HDL-C, P = .59; HDL-P, P = .06; LDL-P, P = .93). ApoB was lower in adrenal venous plasma than in IVC ( P = .026; P < .05 for right adrenal vein). In 13 patients with an aldosterone producing adenoma (APA), apoB was also lower ( P = .045) and LDL-P tended to be lower ( P = .065) in the APA adrenal vein compared with the IVC. ApoA-I was not lower in adrenal venous plasma compared with the IVC, neither in the whole group ( P = .20) nor in the APA subgroup ( P = .075). Conclusion These in vivo observations suggest that circulating LDL may contribute to adrenal steroidogenesis in humans as inferred from adrenal venous-IVC apoB concentration differences. AVS is a feasible method to investigate the relationships between lipoproteins and steroidogenesis. [ABSTRACT FROM AUTHOR]

Background Cholesterol trafficked within plasma lipoproteins, in particular high-density lipoproteins (HDL), may represent an important source of cholesterol that is required for adrenal steroidogenesis. Based on a urinary gas chromatography method, compromised adrenal function has been suggested in men but not in women with (genetically determined) low plasma HDL-cholesterol (HDL-C). Objective The objective of the article was to examine the extent to which glucocorticoid production relates to HDL-C in a population-based cohort. Methods A total of 240 subjects (120 men and 120 women, aged 20–79 years) without relevant comorbidities were recruited from the general population. Glucocorticoid metabolites were measured by gas chromatography with tandem mass spectrometric detection in 24-hour urine collections to estimate total glucocorticoid production (TGP). Fasting plasma (apo)lipoproteins were assayed by routine methods. Results TGP was not decreased but tended to be increased in subjects with low HDL-C (NCEP-ATPIII criteria; P = .094). In univariate analysis, TPG was correlated inversely with HDL-C ( r = −0.353, P < .001) and apoA-I ( r = −0.263, P = .01). Multivariable linear regression analysis demonstrated that TGP was still inversely related to HDL-C (β = −0.145, P = .019) or alternatively to low HDL-C (β = −0.129, P = .013) taking age, sex, current smoking, and other metabolic syndrome components into account. Conclusion In this population-based study, urinary glucocorticoid metabolite excretion was inversely associated with HDL-C. We found no evidence for an attenuated adrenal function in men and women with low HDL-C. [ABSTRACT FROM AUTHOR]

In vitro analysis has indicated that sorghum condensed tannins (SCT) survive simulated gastric digestion and inhibit digestive amylases when encapsulated in sorghum kafirin protein microparticles (SCT-KEMS). This study investigated SCT-KEMS as a potential anti-hyperglycaemic nutraceutical agent in vivo . Oral starch tolerance tests were performed on healthy rats. SCT-KEMS prevented a blood glucose spike and decreased the maximum blood glucose level by 11.8% compared to the water control, the same reduction as the acarbose standard. Neither SCT-KEMS nor acarbose elevated serum insulin levels. Further, the rats took the SCT-KEMS willingly, unlike the case with the unencapsulated SCTs. SCT-KEMS are potentially effective nutraceuticals for the management of hyperglycaemia because of the high affinity of SCT for the proline-rich kafirin and kafirin's slow digestibility, which enables SCT bitterness to be masked and delivered to the small intestine to inhibit carbohydrate hydrolysis, thus reducing glycaemic response. [ABSTRACT FROM AUTHOR]

Background: Treatment of differentiated thyroid carcinoma (DTC) often involves administration of radioactive iodine (I-131) for remnant ablation or adjuvant therapy. As DTC has favorable outcome and the incidence is increasing, concerns have been raised about the possible adverse effects of I-131 therapy. We systematically reviewed the literature to examine the risk of intermediate and long-term adverse effects of I-131 therapy in DTC patients.Methods: Multiple electronic databases were searched up to November 2014 for English-language, controlled studies that reported on the risk of salivary gland dysfunction, lacrimal gland dysfunction, gonadal dysfunction, female reproductive outcomes or second primary malignancies (SPM) after I-131 exposure. The certainty of the evidence found was assessed using GRADE.Results: In total, 37 articles met all inclusion criteria, no studies reporting on adverse effects after I-131 treatment focused solely on children. After exposure to I-131 for DTC, patients experienced significantly more frequently salivary gland dysfunction (prevalence range: 16-54%, moderate-level evidence), lacrimal gland dysfunction (prevalence: 11%, low-level evidence), transient male gonadal dysfunction (prevalence: 35-100%, high-level evidence), transient female gonadal dysfunction (prevalence: 28%, low-level evidence) and SPM (prevalence: 2.7-8.7%, moderate-level evidence) compared to unexposed patients. I-131 therapy seems to have no deleterious effects on female reproductive outcomes (very-low level evidence). The prevalence and severity of adverse effects were correlated to increasing cumulative I-131 activity.Conclusion: Treatment with I-131 for DTC may have significant adverse effects, which seem to be dose dependent. These adverse effects of treatment must be balanced when choosing for I-131 therapy in patients with DTC. [ABSTRACT FROM AUTHOR]

Introduction Type 1 diabetes (T1D) is associated with adverse pregnancy outcome, usually attributed to hyperglycemia. Recently, we showed that pregnancy outcome in normoglycemic T1D rats was characterized by decreased fetal and placental weight, suggesting impaired placental development. In the present study, we tested the hypothesis that trophoblast invasion and spiral artery (SA) remodeling is impaired in T1D rats ant that this is associated with aberrant local presence of NK cells and macrophages in the mesometrial triangle (MT). Methods Placentae with MT from pregnant biobreeding diabetes-prone (BBDP; T1D model) rats, control biobreeding diabetes-resistant (BBDR) and Wistar-rats were dissected at day 18 of gestation and stained for trophoblast invasion, SA remodeling, uNK cells and macrophages. Results Interstitial trophoblast invasion and SA remodeling was impaired in BBDP-rats vs. control rats, coinciding with increased presence of NK cells and an increased iNOS+/CD206+ ratio of macrophages. Discussion Decreased fetal and placental weight in BBDP-rats was associated with diminished interstitial trophoblast invasion and less optimal SA remodeling, increased numbers of NK cells and increased iNOS+/CD206+ macrophage ratio in the MT of BBDP-rats. Conclusions The impaired trophoblast invasion and SA remodeling may be due to an aberrant local immune-response and may result in damage to the fetal placenta and insufficient supply of nutrients towards the fetus with eventually decreased fetal weight as a consequence. [ABSTRACT FROM AUTHOR]

Background There is no international consensus on surveillance strategies for differentiated thyroid carcinoma (DTC) after radiotherapy for childhood cancer. Ultrasonography could allow for early detection of DTC, however, its value is yet unclear since the prognosis of DTC is excellent. We addressed the evidence for the question: ‘is outcome of DTC influenced by tumor stage at diagnosis?’. Methods A multidisciplinary working group answered the sub-questions: ‘is recurrence or mortality influenced by DTC stage at diagnosis? Does detection of DTC at an early stage contribute to a decline in adverse events of treatment?’ The literature was systematically reviewed, and conclusions were drawn based on the level of evidence (A: high, B: moderate to low, C: very low). Results In children, level C evidence was found that detection of DTC at an early stage is associated with lower recurrence and mortality rates. No evidence was found that it influences morbidity rates. In adults, clear evidence was found that less advanced staged DTC is a favorable prognostic factor for recurrence (level B) and mortality (level A). Additionally, it was found that more extensive surgery increases the risk to develop transient hypoparathyroidism (level A) and that higher doses of radioiodine increases the risk to develop second primary malignancies (level B). Conclusion Identification of DTC at an early stage is beneficial for children (very low level evidence) and adults (moderate to high level evidence), even considering that the overall outcome is excellent. These results are an important cornerstone for the development of guidelines for childhood cancer survivors at risk for DTC. [ABSTRACT FROM AUTHOR]

Type 2 diabetes (T2D) is increasing rapidly in Africa. An appropriate therapeutic approach is to inhibit intestinal carbohydrate digesting enzymes using plant polyphenols. A crude preparation of sorghum condensed tannins (SCT) was highly effective (approx. 20,000 times) at inhibiting α-glucosidase compared to acarbose, while acarbose was a better α-amylase inhihitor (approx. 180 times). Kafirin microparticles (KEMS) were investigated as an oral delivery system for SCT. Using a simple aqueous alcohol coacervation method, the encapulation efficiency of SCT in the KEMS was approx. 48%. Quantitative data and electron microscopy revealed that KEMS encapsulating SCT were digested to only a limited extent during simulated gastrointestinal digestion with pepsin and trypsin–chymotrypsin. Hence, SCT encapsulated in KEMS retained their inhibitory activity against both amylases, throughout simulated gastrointestinal digestion, whereas unencapsulated SCT lost most of their inhibitory activity. Thus, KEMS encapsulating SCT have potential as a nutraceutical to attenuate hyperglycaemia and control T2D. [ABSTRACT FROM AUTHOR]

Abstract: D.R. Zeigler determined that the sequence identity of bacterial genomes can be predicted accurately using the sequence identities of a corresponding set of genes that meet certain criteria . This three-gene model for comparing bacterial genome pairs requires the determination of the sequence identities for recN, thdF, and rpoA. This involves the generation of approximately 4.2kb of genomic DNA sequence from each organism to be compared, and also normally requires that oligonucleotide primers be designed for amplification and sequencing based on the sequences of closely related organisms. However, we have developed an analogous mathematical model for predicting the sequence identity of whole genomes based on the sequence identity of the 542–567 base pair chaperonin-60 universal target (cpn60 UT). The cpn60 UT is accessible in nearly all bacterial genomes with a single set of universal primers, and its length is such that it can be completely sequenced in one pair of overlapping sequencing reads via di-deoxy sequencing. These mathematical models were applied to a set of Thermoanaerobacter isolates from a wood chip compost pile and it was shown that both the one-gene cpn60 UT-based model and the three-gene model based on recN, rpoA, and thdF predicted that these isolates could be classified as Thermoanaerobacter thermohydrosulfuricus. Furthermore, it was found that the genomic prediction model using cpn60 UT gave similar results to whole-genome sequence alignments over a broad range of taxa, suggesting that this method may have general utility for screening isolates and predicting their taxonomic affiliations. [Copyright &y& Elsevier]

Summary: Posterior interosseous nerve palsy is a recognized complication of 2-incision distal biceps tendon repair. We hypothesize that intraoperative forearm pronation can cause compression of the posterior interosseous nerve beneath the supinator and arcade of Frohse. Six human male cadaver upper extremities were dissected. Pressure on the posterior interosseous nerve beneath the arcade of Frohse and supinator was measured with a Swan-Ganz catheter connected to a pressure transducer. Pressure was significantly elevated in maximal pronation in all specimens with the elbow in both flexion and extension. Pressures at full pronation were significantly higher than pressures measured at 60° of pronation (5 ± 2 mm Hg in 60° of pronation and 90° of flexion, P < .0001; 7 ± 3 mm Hg in 60° of pronation and extension, P < 005). Maximal pronation can cause increased pressure on the posterior interosseous nerve. The safety of 2-incision distal biceps repair may be increased by avoiding prolonged, uninterrupted periods of hyperpronation. [Copyright &y& Elsevier]

Purpose: To compare clinical and radiographic outcomes in patients with chronic scapholunate dissociation treated with a modified Brunelli technique versus a 4-bone tendon weave. Methods: A retrospective cohort study was performed. Twenty-three patients presented with chronic scapholunate dissociation and were treated with the 4-bone tendon weave technique as described by Almquist and colleagues. A separate group of 21 patients were subsequently treated with a modified Brunelli plus reduction-assisted scapholunate ligament technique. All patients had preoperative radiographs demonstrating scapholunate ligament disruption and positive magnetic resonance arthrograms. All were treated by the senior surgeon (T.E.T.), who initially performed the 4-bone tendon weave and later the modified Brunelli procedure plus temporary screw fixation. Evaluation included radiographic changes, pain and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire scores, grip strength, and range of motion. Data were analyzed using the Wilcoxon signed rank test for preoperative-to-postoperative comparisons and the Wilcoxon-Mann-Whitney test for comparison between the 2 treatment groups. Results: The scapholunate angle decreased in both groups (mean 15° ± 5 decrease for the Brunelli group; 10° ± 4 decrease in the 4-bone tendon weave group). Mean pain and DASH scores preoperatively and postoperatively demonstrated greater improvement for the modified Brunelli group (pain scores rated on a visual analog scale of 1 to 10: mean difference Brunelli group = 4.8 cm; 4-bone tendon weave group = 3.2 cm; mean difference 1.6 cm; DASH scores: mean difference Brunelli group = 31.5 points; 4-bone tendon weave group = 14.2 points). The Brunelli group also experienced greater postoperative motion as a percentage of preoperative motion (mean 86% ± 7 vs 60% ± 12) and significant increases in postoperative versus preoperative grip strength (mean 2 kg vs 1 kg; increase of 1 kg). Conclusions: The modified Brunelli technique for scapholunate interosseous ligament reconstruction compared with the 4-bone tendon weave technique has improved outcomes in pain relief, DASH scores, range of motion, and grip strength at 2.5 years follow-up. Type of study/level of evidence: Therapeutic III. [Copyright &y& Elsevier]

Abstract: The prevalence of borderline personality disorder (BPD) in outpatient clinics varies greatly (7%-27%) depending on the setting and methodology. We examined the cross-sectional rate of BPD in a general adult outpatient university clinic using a 2-phase procedure: (1) we screened all registered patients with the self-report SCID-II-PQ and (2) we administered the Revised Diagnostic Interview for Borderlines (DIB-R). Sixty-six percent (239/360) of the clinic patients completed the screening: About 72.4% (173/239) (95% confidence interval [CI] = 66.7%, 78.1%) were positive for BPD on the Structured Clinical Interview for DSM-IV Personality Disorders–Patient Questionnaire (SCID-II-PQ), and 22.6% (54/239) (95% CI = 17.3%, 27.9%) were positive for BPD on the DIB-R. Our BPD rate was somewhat higher than recent semistructured interview studies (9%-18%). We believe this is due, in part, to our cross-sectional design and our decision not to exclude acute Axis I disorders. Mostly, however, we believe that our 22.6% incidence of BPD arises from the high morbidity of our sample. Demographic data from 130 of 131 DIB-R completers reveal the following: mean age was 40.2 years, 75.4% were female, most patients were unable to work, and they averaged 3.8 lifetime hospitalizations. [Copyright &y& Elsevier]

Objective: Narcissistic personality (NP) has been implicated as a potential vulnerability factor for late-life suicide. The present study investigated whether NP increases vulnerability to suicidal ideation and behavior among geriatric depression day-hospital patients. Methods: Using a retrospective database analysis, the authors examined demographic data, diagnostic information, and scores on self-report (Geriatric Depression Scale [GDS]) and clinician-rated depression measures (Hamilton Rating Scale for Depression [HAM-D]), for 608 geriatric psychiatry patients 65 years or older. Results: Of the 538 patients meeting study inclusion criteria, 20 had NP, defined as either narcissistic personality disorder (n = 13) or narcissistic personality traits (n = 7). Patients with NP were rated significantly higher on the HAM-D suicide item than those without NP, controlling for age, sex, depression (GDS), and cognitive functioning. Conclusion: Findings suggest that NP may be a clinical marker of elevated suicide risk among depressed older adults. Clinicians are advised to assess the presence of self-pathology and its potential impact upon psychological functioning in depressed older patients, and to incorporate discussions of life transitions into therapeutic work with those at-risk for suicide. [ABSTRACT FROM AUTHOR]

Abstract: Aims: Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy has been reported as a treatment option for patients with peritoneal carcinomatosis from colorectal carcinoma. Methods: Thirty patients with colorectal peritoneal carcinomatosis underwent cytoreductive surgery and perioperative intraperitoneal chemotherapy. All appendiceal cancers were excluded. All patients were followed until January 2006 or death. Univariate analysis was performed to evaluate significant prognostic factors for overall survival, defined from the time of surgery. Results: There were 13 male patients. The mean age at the time of surgery was 54years. There was no hospital mortality. The mean duration of hospital stay was 27days. The overall median survival was 29months, with 1- and 2-year survival of 72% and 64%, respectively. Twenty-one patients had complete cytoreduction and their 1- and 2-year survival rates were 85% and 71%, respectively. Univariate analysis demonstrated that patients with non-mucinous colorectal adenocarcinoma, Peritoneal Cancer Index (PCI) ≤13, and complete cytoreduction were associated with an improved survival. Conclusions: This study reported on 30 patients who underwent cytoreductive surgery and perioperative intraperitoneal chemotherapy for colorectal peritoneal carcinomatosis. Patients with mucinous tumour had relatively more extensive intraperitoneal disease. Non-mucinous colorectal adenocarcinoma, PCI ≤13, and complete cytoreduction were associated with an improved survival. [Copyright &y& Elsevier]

Background: Activating mutations in the RET gene, which encodes a tyrosine kinase receptor, often cause medullary thyroid carcinoma (MTC). Surgical resection is the only curative treatment; no effective systemic treatment is available. We evaluated imatinib, a tyrosine kinase inhibitor currently used to treat chronic myelogenous leukemia and gastrointestinal stromal tumors, as a potential drug for systemic treatment of MTC, in 2 MTC-derived cell lines expressing multiple endocrine neoplasia–associated mutant RET receptors. Methods: We determined RET expression and Y1062 phosphorylation using Western blot analysis and quantitative polymerase chain reaction. We determined the effects on cell proliferation by a 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay, and we used fluorescence-activated cell sorter analysis with annexin V/propidium iodide staining to study imatinib-induced cell-cycle arrest, apoptosis, and cell death. Results: Imatinib inhibited RET Y1062 phosphorylation in a dose-dependent manner after 1.5 hours of exposure. After 16 hours both RET Y1062 phosphorylation and protein expression levels were affected. Dose-dependent decreases in cell proliferation of both cell lines after exposure to imatinib with inhibitory concentration of 50% levels of 23 ± 2 μmol/L and 25 ± 4 μmol/L were seen. These values are high, compared with those for chronic myelogenous leukemia and gastrointestinal stromal tumors. We further could show that imatinib induced cell-cycle arrest, and apoptotic and nonapoptotic cell death. Conclusions: Imatinib inhibits RET-mediated MTC cell growth affecting RET protein levels in vitro in a dose-dependent manner. The concentration of imatinib necessary to inhibit RET in vitro, however, makes it impossible to conclude that imatinib monotherapy will be a good option for systemic therapy of MTC. [Copyright &y& Elsevier]

Objective: The purpose of this study was to use a novel method that was based on the application of chaperonin-60 sequencing to describe the vaginal microflora of 16 healthy women. Study design: Asymptomatic women consented for vaginal swabs to be collected at the time of a clinical pelvic examination. Total genomic DNA was isolated from the vaginal swabs. Degenerate, universal polymerase chain reaction primers were used to amplify an approximately 555 base pair region of the universal chaperonin-60 gene, which is found in all eubacteria and eukaryotes, from the total genomic DNA and libraries of cloned polymerase chain reaction products were constructed. Library clones were sequenced, and the resulting sequences were assigned to taxonomic groups on the basis of similarity to reference sequence data. Presence of Chlamydophila psittaci sequences in the samples was confirmed by species-specific polymerase chain reaction. Results: Sixteen of the 23 women who were enrolled had normal flora by Nugent's score of <4 and had adequate polymerase chain reaction product for assessment. Vaginal flora libraries were dominated by a variety of sequences with similarity to Lactobacillus spp L crispatus, L iners, L gasseri, L jensenii, and L buchneri. Other sequences that were identified included representatives of Gardnerella spp, sequences with similarity to Porphyromonas spp and Megasphaera spp and sequences identical to C psittaci. Conclusion: Culture-independent, chaperonin-60 sequence-based molecular methods can lead to the identification of greater diversity within defined taxa compared with those that are identified by standard culture-based methods and to the identification of novel organisms that were not previously associated with vaginal-flora. [ABSTRACT FROM AUTHOR]

Objective: To determine whether basal ganglia atrophy, known to be associated with apathy in nondementia populations, was associated with presence of apathy in patients with frontotemporal dementia (FTD). Methods: A cross-sectional case study was conducted at two tertiary dementia care clinics in Toronto, Ontario, Canada. Striatal and thalamic gray matter volumes and apathy measures were collected from 21 subjects with FTD, 6 of whom did not show apathy on the Neuropsychiatric Inventory. Results: No significant differences in gray matter volumes were found between apathetic and nonapathetic groups for the striatum or the thalamus. Conclusions: Our findings imply that the etiology of apathy seen in patients with FTD differs from that of patients with apathy after acquired injuries to the basal ganglia. Further study is needed to determine whether posterior thalamic atrophy correlates with apathy in FTD or functional imaging techniques might successfully find a relationship between basal ganglia dysfunction and apathy. [ABSTRACT FROM AUTHOR]

B Background: b Guidelines for treatment of differentiated thyroid cancer (DTC) in the Netherlands were introduced in 2007 (NL-07) and revised in 2015 (NL-15). This study aims to evaluate both Dutch guidelines (NL-07 and NL-15) and compare them with the current ATA guideline (ATA-15) to assess potential under- and overtreatment. B Results: b When comparing NL-15 with ATA-15, there was significantly more under-treatment in the ATA-15, significantly more over-treatment in the NL-15, but also significantly more adequate treatment in the NL-15. [Extracted from the article]

Objective Advanced glycation end products (AGEs) are implicated in the pathogenesis of cardiovascular disease. Accumulation of AGEs is driven by oxidative or glycemic stress and can be assessed by skin autofluorescence (SAF). SAF is increased in patients with peripheral artery disease (PAD) and independently associated with mortality and major adverse cardiovascular events in these patients. PAD and abdominal aortic aneurysm (AAA) share several risk factors. Inflammation is an important process in AAA formation and increases levels of oxidative stress. We therefore hypothesized that SAF would be increased in AAA patients compared with controls. Methods A case-control study was performed in 248 AAA patients and 124 controls without AAA or PAD matched for age and presence of diabetes mellitus. SAF was noninvasively assessed with the AGE Reader (Diagnoptics Technologies BV, Groningen, The Netherlands). Results SAF was higher in AAA patients than in controls: 2.89 ± 0.63 vs 2.68 ± 0.63 arbitrary units ( P = .003). PAD comorbidity was associated with increased SAF within the AAA patient group ( P = .01). After correction for known factors influencing SAF (age, current smoking, hypertension, and estimated glomerular filtration rate), PAD comorbidity remained an independent determinant of SAF. Logistic regression analysis of the total cohort showed an unadjusted odds ratio (OR) of 1.74 (95% confidence interval [CI], 1.20-2.51) for the presence of AAA with each unit increase of SAF and an adjusted OR of 1.78 (95% CI, 1.22-2.60) after correction for cardiovascular comorbidity (cerebrovascular disease and coronary artery disease). After additional correction for sex, current smoking, hypertension, and use of lipid-lowering drugs, this significance was lost (adjusted OR, 1.53; 95% CI, 0.94-2.48). Conclusions Skin accumulation of AGEs, measured by SAF, is increased in patients with AAA compared with controls without AAA or PAD, independent of the presence of coronary artery disease and cerebrovascular disease. In AAA patients, SAF is closely associated with the presence of PAD and cardiovascular risk factors. [ABSTRACT FROM AUTHOR]

Background In multiple endocrine neoplasia type 1 (MEN1), pancreatic neuroendocrine tumors (pNETs) are the leading MEN1-related cause of death. Objective To evaluate EUS and 11 C-5-hydroxytryptophan positron emission tomography ( 11 C-5-HTP PET), compared with the recommended screening techniques in MEN1 patients for early detection of pNETs. Design Cross-sectional study. Setting Tertiary-care university medical center. Patients This study involved 41 patients with a proven MEN1 mutation or with one MEN1 manifestation and a mutation carrier as a first-degree family member, with recent screening by abdominal CT or magnetic resonance imaging (MRI) and somatostatin receptor scintigraphy (SRS). Interventions EUS by using a linear Pentax echoendoscope and Hitachi EUB-525 and 11 C-5-HTP PET. Main Outcome Measurements Patient-based and lesion-based positivity for pNET was calculated for all imaging techniques. The McNemar test was used to compare the yield of the 4 imaging techniques. Results In 35 of 41 patients, 107 pancreatic lesions were detected in total. EUS detected 101 pancreatic lesions in 34 patients, 11 C-5-HTP PET detected 35 lesions in 19 patients, and CT/MRI + SRS detected 32 lesions in 18 patients ( P < .001). 11 C-5-HTP PET performed similarly to CT/MRI + SRS and better compared with SRS only (13 lesions in 12 patients), both at a patient-based and lesion-based level ( P < .05). Limitations Single-center study. Conclusion EUS is superior to CT/MRI + SRS for pancreatic lesion detection in patients with MEN1. In this setting, 11 C-5-HTP PET is not useful. We recommend EUS as the first-choice pancreas imaging technique in patients with MEN1. (Clinical trial registration number: NTR1668 .) [ABSTRACT FROM AUTHOR]