Improvement in diagnosis of breast tumour using ultrasound elastography and echography: A phantom based analysis

Due to the isoechoic nature of lesions and their poor contrast with neighbouring tissue, a lesion may remain undetected in ultrasound B mode imaging for cancerous tissue. Imaging of the elastic properties of tissue provides new information which is collateral to tissue pathology. This study provides quantitative analysis of improvements in tumour diagnosis when the ultrasound B mode imaging is combined with elastography. Quantification was based on the textural parameters measured from the ultrasound B mode image and strain measured from the elastogram. The ability of a parameter to discriminate between diseased cases and normal cases was evaluated using receiver operating characteristic (ROC) analysis. Polyacrylamide gel based tissue mimicking phantoms with embedded inclusions of varying stiffness were used for the analysis.     

Dynamics of prevalence of arterial hypertension and other risk factors of development of cardiovascular diseases in female population of Tallin (10 year prospective study)

Aim of the study was to assess dynamics of prevalence of arterial hypertension (AH) and main cardiovascular risk factors (RF) in a women population of Tallin during 10 years of follow up. In 2008-2009 we repeated measurements of arterial pressure (AP), electrocardiographic, echocardiographic, and complex laboratory examinations in 314 participants of epidemiological study undertaken in 1999-2000. Most prevalent RF was hypercholesterolemia. Rate of its detection substantially rose from 69.1 to 81.2%. Number of subjects who continuously took cholesterol lowering drugs and had target levels of lipid profile was sporadic. Prevalence of hypertriglyceridemia, obesity, and diabetes mellitus insignificantly increased. Only prevalence of smoking had tendency to reduction. AH was found in 28.7 and 44.6% of women in 1999-2000 and 2009, respectively. Obesity and hypercholesterolemia contributed significantly to development of new cases of AH. Among subjects with AH 25% of women received antihypertensive therapy and achieved target AP levels--3 times more than in 2000. Thus prevalence of AH and other main RF in female population of Tallin increased during 10 years follow-up. However control of AP in patients with AH notably improved.     

Pharmacoeconomic assessment of therapy for invasive aspergillosis

Invasive aspergillosis (IA) is a major cause of morbidity and mortality in immunocompromised hosts. Economic expenditures prompted by this invasive fungal infection (IFI) are significant. Although, the duration and associated costs of hospitalization comprise the largest proportion of costs in large surveillance studies, the newer oral antifungal agents may impact significantly on these costs. A review of the pharmacoeconomic (PE) studies is provided focussing on primary therapy, salvage therapy, empiric therapy and prophylaxis for IA. PE evaluations have demonstrated the cost effectiveness and dominance of voriconazole for targeted primary treatment of IA compared with other available agents. Differences in the drug choice and analytic methodology of the PE analyses of empiric antifungal strategy hamper definitive conclusions about the agents employed as empiric antifungal that may be directed at suspected IA although both caspofungin and voriconazole appear to be cost effective and dominant over liposomal amphotericin B (LAmB), whereas LAmB is more costly than conventional amphotericin B. Posaconazole is the most cost‐effective agent for antifungal prophylaxis against IFI and IA.     

Cortistatin-17 and -14 exert the same endocrine activities as somatostatin in humans.

Cortistatin (CST) is a neuropeptide, which binds with high affinity all somatostatin (SS) receptor subtypes and shows high structural homology with SS itself. A receptor specific for CST only, i.e., not recognized by SS, has been recently described in agreement with data reporting that not all CST actions are shared by SS. Interestingly, CST but not SS also binds ghrelin receptor (GHS-R1a) in vitro, suggesting a potential interplay between CST and ghrelin system. The aim of this study was to investigate in humans the endocrine and metabolic activities of human CST-17 in comparison with rat CST-14 that has previously been shown to exert the same endocrine actions of SS in healthy volunteers. To this aim, in six healthy male volunteers (age [median, 3rd-97th centiles]: 28.5; 23.6-34.3 years; Body Mass Index: 23.5; 21.0-25.1 kg/m(2)), we studied the effects of human CST-17 (2.0 microg/kg/h iv over 120 min), rat CST-14 (2.0 microg/kg/h iv over 120 min) and SS-14 (2.0 microg/kg/h iv over 120 min) on: (a) spontaneous GH, ACTH, PRL, cortisol, insulin and glucose levels; (b) the GH responses to GHRH (1.0 microg/kg iv at 0 min); (c) the GH, PRL, ACTH, cortisol, insulin and glucose responses to ghrelin (1.0 microg/kg iv at 0 min). CST-17 inhibited (p < 0.01) basal GH secretion to the same extent of CST-14 and SS-14. Spontaneous PRL, ACTH and cortisol secretion were not significantly modified by CST-17, CST-14 or SS-14. CST-17 as well as CST-14 and SS-14 also inhibited (p < 0.05) spontaneous insulin secretion to a similar extent. None of these peptides modified glucose levels. The GH response to GHRH was inhibited to the same extent by CST-17 (p < 0.01), CST-14 (p < 0.01) and SS-14 (p < 0.05 ). The ghrelin-induced GH response was higher than that elicited by GHRH (p < 0.01) and inhibited by CST-17 (p < 0.05) as well as by CST-14 (p < 0.05) and SS-14 (p < 0.01). The PRL, ACTH and cortisol responses to ghrelin were unaffected by CST-17, CST-14 or SS-14. On the other hand, the inhibitory effect of ghrelin on insulin levels was abolished by CST-17, CST-14 or SS-14 (p < 0.05) that, in turn, did not modify the ghrelin-induced increase in glucose levels. In conclusion, this study demonstrates that human CST-17 and rat CST-14 exert the same endocrine activities of SS in humans. The endocrine actions of human and rat CST therefore are likely to reflect activation of classical SS receptors.     

血清HE4与CA125联合检测在上皮性卵巢癌风险评估中的应用

目的探讨血清人附睾上皮分泌蛋白4(HE4)与CA125联合检测在卵巢癌风险评估中的应用价值。方法采用CMIA法检测78例上皮性卵巢癌、41例妇科良性病变及50例健康对照者血清HE4和CA125水平。结果 (1)在未绝经组中,卵巢癌患者HE4与CA125水平明显高于卵巢良性疾病组和健康对照组(P<0.01)。(2)在绝经组中,卵巢癌患者HE4与CA125水平也明显高于卵巢良性疾病组和健康对照组(P<0.01)。(3)在未绝经组中,HE4单项检测对卵巢癌预测的特异度、阳性预测值(分别为95.7%和90.9%)高于CA125单项检测的特异度、阳性预测值(分别为69.9%和60.0%)。(4)在绝经组中,HE4单项检测对卵巢癌预测的特异度、阳性预测值(分别为92.7%和92.1%)也高于CA125单项检测的特异度、阳性预测值(分别为66.0%和69.2%)。(5)对于卵巢疾病患者,未绝经者与绝经者卵巢发病风险计算>7.4%和25.3%时,可能存在卵巢癌发病的高风险。结论 HE4是一种较理想的卵巢癌肿瘤标志物,HE4与CA125敏感性相当,但HE4单项检测诊断卵巢恶性肿瘤的特异性优于CA125单项检测,联合CA125检测对评估患卵巢癌的风险性有重要价值。