Exhaled markers in the monitoring of airways inflammation and its response to steroid's treatment in mild persistent asthma

The measure of inflammatory cytokines in the exhaled breath condensate has been recently proposed for use in monitoring asthma and the therapeutic response to steroids. The aim of the present study was to investigate the usefulness of measuring exhaled IL-6, IL-4 and pH in mild persistent asthma. Furthermore the effects on these markers of inhaled steroids were assessed. The study enrolled 28 asthmatic (15 males, 38+/-12 years) and 15 healthy subjects (5 males, 35+/-6 years). IL-6, IL-4 and pH were measured in the exhaled breath condensate of the subjects studied. Significantly higher concentrations of IL-6 and IL-4 were observed in the breath condensate of asthmatic patients (7.1+/-1.1 and 64.4+/-8.3 pg/ml) compared to controls (2.7+/-0.6 and 31.7+/-3.5 pg/ml), p<0.001. Furthermore, exhaled IL-4 fell significantly after treatment with inhaled steroids for 6 months (47.9+/-3.2 pg/ml, p<0.001) while exhaled IL-6 did not (6.4+/-1.0 pg/ml, p=0.8). The exhaled pH turned out to be lower in asthmatic subjects than in controls (7.39+/-0.11 vs. 7.85+/-0.14; P<0.001) but trended towards control levels after steroid treatment (7.65+/-0.16, P<0.001). We conclude that the measurement of exhaled IL-4 and pH in mild asthmatic subjects could be a useful way of monitoring their airway inflammation as well as their response to the treatment.     

Protocol modifications for CT perfusion (CTp) examinations of abdomen-pelvic tumors: Impact on radiation dose and data processing time

Purpose  

To evaluate the effect of CT perfusion (CTp) protocol modifications on quantitative perfusion parameters, radiation dose and data processing time.     

Exposure to HAV infection in patients with chronic liver disease in Italy, a multicentre study

We carried out a multicentre study on 2830 patients with chronic liver disease from 79 liver units (25 in northern, 24 in central and 30 in southern Italy) to evaluate naturally acquired immunity against hepatitis A virus (HAV) in relation to age, sex, geographical area of origin and entity of liver disease, and to define the strategy for specific vaccination. Antibody to HAV (anti-HAV) was detected in 1514 (53.5%) of the 2830 patients tested; the prevalence was 50.4% in males and 59.1% in females. Both in central and southern Italy the prevalence of anti-HAV positive subjects increased with increasing age from 43.3 and 44.7%, respectively, in the 0-30-year-old subjects to 80.1 and 68.3%, respectively, in those aged over 60 years. The overall prevalence was much lower in northern Italy, as were the variations from one age group to another, from 28.4% in the 0-30-year-old subjects to 38% in those aged over 60 years. 40.6% of patients with cirrhosis lacked naturally acquired protection against HAV; this percentage was higher in northern (60.5%) than in central (34.9%, P < 0.0001) and southern Italy (27.6%, P < 0.0001). The high prevalence of patients in Italy with chronic hepatitis or cirrhosis who lack naturally acquired immunity to HAV warrants the implementation of vaccination programmes against hepatitis A in such patients.     

The Cross-Generational Mother–Daughter–Aunt–Niece Design: Establishing Validity of the MDAN Design with NLSY Fertility Variables

Using National Longitudinal Survey of Youth (NLSY) fertility variables, we introduce and illustrate a new genetically-informative design. First, we develop a kinship linking algorithm, using the NLSY79 and the NLSY-Children data to link mothers to daughters and aunts to nieces. Then we construct mother–daughter correlations to compare to aunt–niece correlations, an MDAN design, within the context of the quantitative genetic model. The results of our empirical illustration, which uses DF Analysis and generalized estimation equations (GEE) to estimate biometrical parameters from NLSY79 sister–sister pairs and their children in the NLSY-Children dataset, provide both face validity and concurrent validity in support of the efficacy of the design. We describe extensions of the MDAN design. Compared to the typical within-generational design used in most behavior genetic research, the cross-generational feature of this design has certain advantages and interesting features. In particular, we note that the equal environment assumption of the traditional biometrical model shifts in the context of a cross-generational design. These shifts raise questions and provide motivation for future research using the MDAN and other cross-generational designs. Edited by Danielle Dick.     

Evaluation of serum biomarkers in nutritional disorders: glycated apolipoprotein B, fasting serum glucose, fructosamine, stable and labile glycated hemoglobin in diabetic and non-diabetic subjects

Glycated apolipoprotein B (ApoB-G), a non enzymatically glycated protein, has recently been associated with myocardial infarction. Our aim is to evaluate, in diabetic and non diabetic subjects, the relationship of ApoB-G with serum fasting glucose, fructosamine, stable and labile fractions of glycated hemoglobin ((S)HbA(1c), (L)HbA(1c), respectively) and insulin. The subjects were recruited from a previous study on ApoB-G and myocardial infarction: 141 of them were studied, 43 with and 98 without diabetes. ApoB-G was measured using a monoclonal antibody, and linear regression and correlation were used for statistical analysis of the data. ApoB-G was higher in diabetic than in non diabetic subjects. There was a statistically significant correlation of ApoB-G with triglycerides (r = 0.38, p = 0.01) in diabetic subjects, and with total proteins (r = 0.37, p = 0.0002), triglycerides (r = 0.34, p = 0.0007), and cholesterol (r = 0.23, p = 0.02) in non diabetic subjects. In the most parsimonious multiple linear regression model of ApoB-G on all the other serum variables, there was a statistically significant association of ApoB-G with triglycerides, in both diabetic and non diabetic subjects. The main results of this study suggest that serum ApoB-G is associated with serum triglycerides in both diabetic and non diabetic subjects.     

MDCT coronary angiography vs 2D echocardiography for the assessment of left ventricle functional parameters

Purpose

This study was done to compare the parameters of left ventricular (LV) function obtained by multidetector computed tomography coronary angiography (MDCT-CA) using 64-slice equipment with those obtained using twodimensional echocardiography (2D-SE) considered as reference standard.

Materials and methods

Between April 2008 and September 2009, 116 consecutive patients were studied with both techniques. We analysed the parameters commonly sampled in echocardiography and related them with those retrieved with MDCT-CA: septal thickness, posterior wall thickness, diameter of ascending aorta, diameter and volumes in end-systolic and end-diastolic phase, ejection fraction, stroke volume, cardiac output and heart mass.

Results

Good correlation was found measuring septal thickness (r=0.470; p=0.001), and diameters of the ascending aorta. Correlation between systolic and diastolic diameters obtained with the two techniques was good. Poor correlation was attained measuring thickness of the posterior wall (r=0.243; p=0.104). MDCT-CA consistently overestimated the average volumes; diastolic and systolic volumes showed significant correlation (r=0.0456; p= 0.002; r=0.640; p<0.001). Ejection fraction agreement showed a significant correlation (r=0.626; p<0.001).

Conclusions

MDCT-CA provides parameters of cardiac function comparable to those found in echocardiography. MDCT-CA although used primarily for coronary noninvasive imaging can provide additional information on ventricular function useful to the diagnostic workup of cardiac patients.     

Relationship between functional imaging and immunohistochemical markers and prediction of breast cancer subtype: a PET/MRI study

Purpose

The aim of this study was to determine if functional parameters extracted from the hybrid positron emission tomography/magnetic resonance imaging (PET/MRI) correlate with the immunohistochemical markers of breast cancer (BC) lesions, to assess their ability to predict BC subtype.

Methods

This prospective study was approved by the institution’s Ethics Committee, and all patients provided written informed consent. A total of 50 BC patients at diagnosis underwent PET/MRI before pharmacological and surgical treatment. For each primary lesion, the following data were extracted: morphological data including tumour-node-metastasis stage and lesion size; apparent diffusion coefficient (ADC); perfusion data including forward volume transfer constant (Ktrans), reverse efflux volume transfer constant (Kep) and extravascular extracellular space volume (Ve); and metabolic data including standardized uptake value (SUV), lean body mass (SUL), metabolic tumour volume and total lesion glycolysis. Immunohistochemical reports were used to determine receptor status (oestrogen, progesterone, and human epidermal growth factor receptor 2), cellular differentiation status (grade), and proliferation index (Ki67) of the tumour lesions. Correlation studies (Mann–Whitney U test and Spearman’s test), receiver operating characteristic (ROC) curve analysis, and multivariate analysis were performed.

Results

Association studies were performed to assess the correlations between imaging and histological prognostic markers of BC. Imaging biomarkers, which significantly correlated with biological markers, were selected to perform ROC curve analysis to determine their ability to discriminate among BC subtypes. SUV_max, SUV_mean and SUL were able to discriminate between luminal A and luminal B subtypes (AUC_SUVmean?=?0.799; AUC_SUVmax?=?0.833; AUC_SUL?=?0.813) and between luminal A and nonluminal subtypes (AUC_SUVmean?=?0.926; AUC_SUVmax?=?0.917; AUC_SUL?=?0.945), and the lowest SUV and SUL values were associated with the luminal A subtype. Kep_max was able to discriminate between luminal A and luminal B subtypes (AUC?=?0.779), and its highest values were associated with the luminal B subtype. Ktrans_max (AUC?=?0.881) was able to discriminate between luminal A and nonluminal subtypes, and the highest perfusion values were associated with the nonluminal subtype. In addition, ADC (AUC?=?0.877) was able to discriminate between luminal B and nonluminal subtypes, and the lowest ADC_mean values were associated with the luminal B subtype. Multivariate analysis was performed to develop a prognostic model, and the best predictive model included Ktrans_max and SUV_max parameters.

Conclusion

Using multivariate analysis of both PET and MRI parameters, a prognostic model including Ktrans_max and SUV_max was able to predict the tumour subtype in 38 of 49 patients (77.6%, p?<?0.001), with higher accuracy for the luminal B subtype (86.2%).

     

Combined effect of Neridronate and specific antibiotic therapy in a case of tuberculous spondylodiscitis

Because of the increased incidence of tuberculosis (TB) in recent years, infective spondylitis is still a major problem in the world. In skeletal TB the spine is the most often involved and lumbosacral spine involvement is rare. Nowadays early diagnosis and new medical treatment can reduce the incidence of the serious skeletal sequelae and the number of surgery procedures in spinal TB. We present a case of TB spondylodiscitis characterized by a rapid and progressive clinical and radiological improvement after treatment with Neridronate and chemotherapic drugs. Our data suggest that in the treatment of the TB spondylodiscitis the combined use of these drugs is a good alternative to stimulate bone reparative process to the chemotherapy alone. To our knowledge this is first case of a patient with TB discitis treated with Neridronate. Further studies are necessary to confirm the effectiveness of Neridronate treatment added to antiTB drugs in spondylodiscitis