Evaluation of baseline contractile reserve vs dyssynchrony as a predictor of functional improvement and long term outcome after resynchronization pacing therapy: A radionuclide stress study

Aim  

To assess the predictive value of baseline ventricular dyssynchrony and myocardial contractile reserve (mCR) in identifying responders to cardiac resynchronization therapy (CRT).     

Chapter 12: Systematic Review of Prognostic Tests

A number of new biological markers are being studied as predictors of disease or adverse medical events among those who already have a disease. Systematic reviews of this growing literature can help determine whether the available evidence supports use of a new biomarker as a prognostic test that can more accurately place patients into different prognostic groups to improve treatment decisions and the accuracy of outcome predictions. Exemplary reviews of prognostic tests are not widely available, and the methods used to review diagnostic tests do not necessarily address the most important questions about prognostic tests that are used to predict the time-dependent likelihood of future patient outcomes. We provide suggestions for those interested in conducting systematic reviews of a prognostic test. The proposed use of the prognostic test should serve as the framework for a systematic review and to help define the key questions. The outcome probabilities or level of risk and other characteristics of prognostic groups are the most salient statistics for review and perhaps meta-analysis. Reclassification tables can help determine how a prognostic test affects the classification of patients into different prognostic groups, hence their treatment. Review of studies of the association between a potential prognostic test and patient outcomes would have little impact other than to determine whether further development as a prognostic test might be warranted.     

Future Directions in Research,Treatment and Prevention of HPV-Related Squamous Cell Carcinoma of the Head and Neck

Benign smooth muscle proliferations are relatively rare in the oral cavity. Most are classified as angioleiomyomas, some as hamartomatous growths and a few as cutaneous-type leiomyomas. We present two cases of benign smooth muscle proliferations in the tongue, provide a review, briefly discuss histogenesis and offer a clinico-pathological differential diagnosis.     

Shoulder arthroplasty in alkaptonuric arthropathy: a clinical case report and literature review

Alkaptonuria is a rare hereditary metabolic disease of autosomal recessive inheritance, resulting from deficiency of the enzyme homogentisic acid oxidase. The term “alkaptonuria” was first used in 1859 by Boedeker to describe a patient’s urinary reducing compound, and in 1866, Virchow coined the term “ochronosis” due to typical yellow pigmentation. Deposition of this pigment in articular cartilage leads to ochronotic arthropathy, the most incapacitating complication of alkaptonuria. We report a rare case of shoulder ochronotic arthritis, treated with total shoulder arthroplasty, achieving a successful long-term clinical and radiological outcomes.     

ΤND: A Thyroid Nodule Detection System for Analysis of Ultrasound Images and Videos

In this paper, we present a computer-aided-diagnosis (CAD) system prototype, named TND (Thyroid Nodule Detector), for the detection of nodular tissue in ultrasound (US) thyroid images and videos acquired during thyroid US examinations. The proposed system incorporates an original methodology that involves a novel algorithm for automatic definition of the boundaries of the thyroid gland, and a novel approach for the extraction of noise resilient image features effectively representing the textural and the echogenic properties of the thyroid tissue. Through extensive experimental evaluation on real thyroid US data, its accuracy in thyroid nodule detection has been estimated to exceed 95%. These results attest to the feasibility of the clinical application of TND, for the provision of a second more objective opinion to the radiologists by exploiting image evidences.     

Exposure to isoflavone-containing soy products and endothelial function: A Bayesian meta-analysis of randomized controlled trials

Background and AimsTo determine whether and to what degree exposure to isoflavone-containing soy products affects EF. Endothelial dysfunction has been identified as an independent coronary heart disease risk factor and a strong predictor of long-term cardiovascular morbidity and mortality. Data on the effects of exposure to isoflavone-containing soy products on EF are conflicting.Methods and ResultsA comprehensive literature search was conducted using the PUBMED database (National Library of Medicine, Bethesda, MD) inclusively through August 21, 2009 on RCTs using the keywords: soy, isoflavone, phytoestrogen, EF, flow mediated vasodilation, and FMD. A Bayesian meta-analysis was conducted to provide a comprehensive account of the effect of isoflavone-containing soy products on EF, as measured by FMD. A total of 17 RCTs were selected as having sufficient data for study inclusion. The overall mean absolute change in FMD (95% Bayesian CI) for isoflavone-containing soy product interventions was 1.15% (?0.52, 2.75). When the effects of separate interventions were considered, the treatment effect for isolated isoflavones was 1.98% (0.07, 3.97) compared to 0.72% (?1.39, 2.90) for isoflavone-containing soy protein. The models were not improved when considering study-specific effects such as cuff measurement location, prescribed dietary modification, and impaired baseline FMD.ConclusionsCumulative evidence from the RCTs included in this meta-analysis indicates that exposure to soy isoflavones can modestly, but significantly, improve EF as measured by FMD. Therefore, exposure to isoflavone supplements may beneficially influence vascular health.