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Τετάρτη 25 Ιανουαρίου 2023

Radiological evolution of progestogen‐induced meningioma: A monocentric retrospective study

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Abstract

Context

Cyproterone acetate (CPA) is known to induce meningioma, and recently, nomegestrol acetate (NMA) and chlormadinone acetate (CMA) were also involved. Progestagen-induced meningioma management starts with progestogen discontinuation and is either interventional (surgery and/or radiotherapy) or conservative (clinical and MRI radiological follow-up). We performed a retrospective volumetric radiological outcome study of progestogen-induced meningiomas diagnosed in our hospital.

Method

We analysed progestogen-related meningiomas diagnosed until 30 June 2021, with at least one diagnostic and one follow-up MRI results. Meningioma volumes were centrally retrospectively measured using a T1-weighted 3D millimeter sequence with gadolinium injection on a post-processing console.

Results

We analysed 98 meningiomas of 38 females and one transgender (male-to-female), of which 25 (64.1%) had taken CPA, 7 (17.9%) NMA, 3 (7.7%) CMA, and 4 (10.2%) several progestogens. Eleven patients (24 meningiomas) underwent interventional management, 7 patients had meningiomas followed by conservative or interventional management, and 21 patients (51 meningiomas) had only conservative management. Of these 21 patients, 17 had discontinued their progestogen less than 6 months before, of which 14 (82.3%) had decreased or stable meningioma(s) during a 24-month median follow-up [3 to 75] period.

Overall

four of the 39 patients experienced meningioma progression (three during conservative treatment and one after surgery), including two patients who had continued NMA or CMA treatment several years after diagnosis.

Conclusion

Our study confirms a generally favorable outcome of progestogen-related meningioma after conservative treatment, especially for CPA. It also underlines the need for progestogen discontinuation at meningioma diagnosis.

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Τρίτη 24 Ιανουαρίου 2023

Merkelzellkarzinom

alexandrossfakianakis shared this article with you from Inoreader

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Laryngorhinootologie
DOI: 10.1055/a-1949-3751

Das Merkelzellkarzinom ist ein aggressiver neuroendokriner Tumor, welcher durch schnelles Wachstum und frühzeitige Metastasierung charakterisiert ist. Das mediane Erkrankungsalter liegt zwischen 75–80 Jahren. Mit Zunahme des durchschnittlichen Bevölkerungsalters tritt der einstmals seltene Tumor immer häufiger auf. Neben den klassischen Therapiesäulen Chirurgie, Strahlentherapie und Chemotherapie spielt die Immunonkologie au ch beim Merkelzellkarzinom eine zunehmend wichtige Rolle.
[...]

Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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Δευτέρα 23 Ιανουαρίου 2023

Role of craniofacial phenotypes in the response to oral appliance therapy for obstructive sleep apnea

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Background

Mandibular advancement device (MAD) is a good alternative for patients with obstructive sleep apnea (OSA). However, the treatment response varies among individuals.

Objective

This study aimed to explore the role of craniofacial features in the response to MADs to improve prognostication and patient selection.

Methods

The retrospective trial contained 42 males aged 41.5±9.0 years, and with an apnea-hypopnea index (AHI) of 21.5±13.8 events/h. According to the mandibular plane angle, participants were divided into three groups: low angle (n=13), average angle (n=14), and high angle (n=15). Under monitor of home sleep testing, adjustable MADs were used to titrate the mandible forward from 0 mm with an increment of 0.5 mm every day. The polysomnography outcomes, mandibular protrusion amounts, changes in upper airway MRI measurements, and nasal resistance were compared among three groups.

Results

The normalization rate (AHI < 5 /h) was 92.3%, 57.1%, and 46.7% respectively in the low, average, and high angle groups (p=0.027). The effective protrusion where AHI was reduced by half was 20 (11.3~37.5) %, 31.3 (23.6~50) %, and 50 (36.9~64.9) % of the maximal mandibular protrusion, in the low, average, and high angle groups (p=0.004). Multivariate logistic regression revealed that increased gonion angle (OR=0.878) and baseline AHI(OR=0.868) can reduce the probability of normalization.

Conclusion

The high mandibular plane angle might be an unfavorable factor to MAD treatment and more protrusion was needed to achieve a 50% reduction in AHI. Vertical craniofacial pattern (gonion angle) and baseline AHI constituted the model for predicting the effect of MADs.

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GBMdeconvoluteR accurately infers proportions of neoplastic and immune cell populations from bulk glioblastoma transcriptomics data

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Abstract
Background
Characterising and quantifying cell types within glioblastoma (GBM) tumours at scale will facilitate a better understanding of the association between the cellular landscape and tumour phenotypes or clinical correlates. We aimed to develop a tool that deconvolutes immune and neoplastic cells within the GBM tumour microenvironment from bulk RNA sequencing data.
Methods
We developed an IDH wild-type (IDHwt) GBM-specific single immune cell reference consisting of B cells, T cells, NK cells, microglia, tumour associated macrophages, monocytes, mast and DC cells. We used this alongside an existing neoplastic single cell-type reference for astrocyte-like, oligodendrocyte- and neuronal-progenitor like and mesenchymal GBM cancer cells to create both marker and gene signature matrix-based deconvolution tools. We applied single-cell resolution imaging mass cytometry (IMC) to ten IDHwt GBM samples, five paired primary and recur rent tumours, to determine which deconvolution approach performed best.
Results
Marker based deconvolution using GBM tissue specific markers was most accurate for both immune cells and cancer cells, so we packaged this approach as GBMdeconvoluteR. We applied GBMdeconvoluteR to bulk GBM RNAseq data from The Cancer Genome Atlas and recapitulated recent findings from multi-omics single cell studies with regards associations between mesenchymal GBM cancer cells and both lymphoid and myeloid cells. Furthermore, we expanded upon this to show that these associations are stronger in patients with worse prognosis.
Conclusions
GBMdeconvoluteR accurately quantifies immune and neoplastic cell proportions in IDHwt GBM bulk RNA sequencing data and is accessible here: https : // gbmdeconvoluter.leeds.ac.uk
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Κυριακή 22 Ιανουαρίου 2023

Impact of air pollutants on influenza−like illness outpatient visits under COVID−19 pandemic in the sub−center of Beijing, China

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Objective

This study aimed to explore the association between air pollutants and outpatient visits for influenza−like illnesses (ILI) under the coronavirus disease 2019 (COVID−19) stage in the sub−center of Beijing.

Methods

The data on ILI in the sub−center of Beijing from 1 January 2018 to 31 December 2020 were obtained from the Beijing Influenza Surveillance Network. A generalized additive Poisson model was applied to examine the associations between the concentrations of air pollutants and daily outpatient visits for ILI when controlling meteorological factors and temporal trend.

Results

A total of 171,943 ILI patients were included. In the pre−COVID−19 stage, an increased risk of ILI outpatient visits was associated to a high air quality index (AQI) and the high concentrations of particulate matter less than 2.5 (PM2.5), particulate matter 10 (PM10), sulphur dioxide (SO2), nitrogen dioxide (NO2), and carbon monoxide (CO), and a low concentration of ozone (O3) on lag0 day and lag1 day, while a higher increased risk of ILI outpatient visits was observed by the air pollutants in the COVID−19 stage on lag0 day. Except for PM10,the concentrations of other air pollutants on lag1 day were not significantly associated with an increased risk of ILI outpatient visits during the COVID−19 stage.

Conclusion

The findings that air pollutants had enhanced immediate effects and diminished lag-effects on the risk of ILI outpatient visits during the COVID−19 pandemic, which is important for the development of public health and environmental governance strategies.

This article is protected by copyright. All rights reserved.

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Regulatory B cells (Bregs) in Helicobacter pylori chronic infection

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Abstract

Background

Helicobacter pylori (H. pylori) infection is linked with a wide variety of diseases and was reported in more than half of the world's population. Chronic H. pylori infection and its final clinical outcome depend mainly on the bacterial virulence factors and its ability to manipulate and adapt to human immune responses. Bregs blood levels have been correlated with increased bacterial load and infection chronicity, especially Gram-negative bacterial infection. This study aimed to identify prevalence and virulence factors of chronic H. pylori infection among symptomatic Egyptian patients and to examine its possible correlation to levels of regulatory B cells (Bregs) in blood.

Materials and Methods

Gastric biopsies and blood samples from each of 113 adult patients, who underwent upper endoscopy, were examined for the detection of H. pylori by culture and PCR methods. Conventional PCR was used to determine various virulent genes prevalence and association to clinical outcome. Flow cytometry was used to evaluate Bregs levels.

Results

Helicobacter pylori prevalence was 49.1% (55/112). Regarding virulence genes incidence, flaA gene was detected in 73% (40/55), vir B11 in 56.4% (31/55), hopZ1 in 34.5% (19/55), hopZ2 in 89% (49/55), babA2 in 52.7% (29/55), dupA jhp917 in 61.8% (34/55), vacA m1/m2 in 70.9% (39/55), and vacA s1/s2 in 69% (38/55) strains. Bregs levels were significantly lower in H. pylori-infected patients (p = 0.013), while total leukocyte count (TLC) showed no significant differences.

Conclusion

Helicobacter pylori infection prevalence was almost 49%, and the infection was found to be related to inflammatory conditions as gastritis and ulcers rather than malignant transformations. Also, we found that CD24+CD38+ B cells were downregulated in Hpylori-infected patients.

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Developmental Outcomes in Children Born to Women with Possible Subclinical Rubella Exposures During Pregnancy

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Abstract

This study investigated outcomes of children born to women who seroconverted to rubella immune during pregnancy.

In a prior 2012-2013 study of 296 women who were rubella non-immune, 26 (8.8%) seroconverted to rubella immune during pregnancy. These same women and their now 8-9 years-old children were queried as to the children's developmental health. After removing exclusions and those lost to follow-up, the total response rate was 115/204 (56.4%). Three sets of twins in the non-immune group increased the total to 118. The seroconversion group had more autism (12.5% versus 3.9%, P=.19), ADHD (37.5% versus 18.6%, P=.10), and any developmental disability (43.8% versus 31.4%, P=.39) but none showed a statistical difference between the two groups. Compared to Autism and Developmental Disabilities Monitoring data, the seroconversion group had a greater prevalence of autism (OR 6.07, P=0.051, nonsignificant); and to data derived from the National Health Interview Survey, a nonsignificant higher odds of autism (OR 5.57, P=0.060), higher odds of ADHD (OR 5.65, P=0.0027) and of an y developmental disability (OR 3.59, P=0.014).The non-immune group also demonstrated a statistically significant increase for both ADHD and any developmental disability, but not for autism.

This article is protected by copyright. All rights reserved.

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