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1.
Willy Baccaglini Felipe A. Glina Cristiano Linck Pazeto Luis G. Medina Fernando Korkes Wanderley M. Bernardo Rene Sotelo Sidney Glina Giancarlo Marra Marco Moschini Xavier Cathelineau Rafael Sanchez-Salas 《Clinical genitourinary cancer》2021,19(1):3-11.e1
This meta-analysis focuses on the accuracy of upgrading to clinically significant prostate cancer (PCa) by multiparametric magnetic resonance imaging-targeted biopsy (MRI-TB) versus systematic biopsy (SB). We searched the Medline, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Scopus, and Literatura Latino Americana em Ciências da Saúde databases through January 2020 for comparative, retrospective/prospective, paired-cohort, and randomized clinical trials with paired comparisons. The population consisted of patients with low-risk PCa in active surveillance with at least 1 index lesion on imaging. We evaluated the quality of evidence by using the Quality Assessment of Diagnostic Accuracy Studies-2 score. Group comparisons considered the differences between the area under the curve summary receiver operating characteristic curve in a 2-tailed method. We also compared the positive predictive value of the best single method (MRI-TB or SB) and the referral study test (combined biopsy, a combination of MRI-TB and SB). The meta-analysis included 6 studies enrolling 741 patients. The pooled sensitivity for the 2 groups was 0.79 (95% confidence interval, 0.74-0.83; I2 = 75%) and 0.67 (95% confidence interval, 0.63-0.74; I2 = 55.4%), respectively. The area under the curve for the MRI-TB and SB groups were 0.99 and 0.92 (P < .001), respectively. The positive predictive value for the MRI-TB and combined biopsy groups were similar. The accumulated evidence suggests better results for MRI-TB compared with SB. Therefore, use of MRI-TB alone may be preferable in patients in active surveillance harboring low-risk PCa. 相似文献
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Rianne P Reijs Saskia G M van Mil Mariette H J A van Hall Johan B A M Arends Jacobiene W Weber Willy O Renier Albert P Aldenkamp 《Seizure》2007,16(5):438-444
INTRODUCTION: One-third of children with epilepsy are classified as having a cryptogenic localization related epilepsy (CLRE). In cohort studies CLRE is often grouped together with either symptomatic localization related epilepsy (SLRE) or idiopathic generalized epilepsy (IGE). Therefore, this categorization is not specific enough and will not lead to prognostic or treatment information. We objectified the classification differences between these categories. METHODS: A total of 114 children admitted to our epilepsy centre underwent a standardized clinical analysis, which yielded age at onset, duration of the epilepsy, seizure frequency, seizure type, percentage of interictal epileptiform activity on EEG (IEA), type of treatment, and full scale IQ. These variables are regarded the characteristics of the epilepsy, and used in a discriminant function analysis. RESULTS: IEA was found to be the only variable to distinguish between groups of epilepsy. SLRE could easily be distinguished significantly from IGE and CLRE, while the latter two did not differ significantly. Discriminant function analysis combined the variables into two functions, applicable to classify the children. By applying this statistical analysis method, the groups clinically classified as SLRE and IGE were mostly classified as SLRE (71.4%) and IGE (57.9%). However, CLRE appeared difficult to classify (49.2%), and most children were classified as either SLRE (19%) or IGE (31.7%). CONCLUSION: The current opinion that CLRE is 'probably symptomatic' cannot be confirmed in all cases in this study. It is most likely that the current CLRE population consists of both children with eventually SLRE, as well as yet to be described syndromes to be classified as idiopathic epilepsies. We emphasize the need for separate studies regarding children with 'probably symptomatic' (cryptogenic) localization related epilepsy, as this will maximally help children, caretakers and treating physicians to achieve the best possible outcome. 相似文献
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OBJECTIVE: Is there any correlation between follicular fluid (FF) steroid levels and the occurrence of cytogenetic abnormalities in unfertilized human oocytes? DESIGN: Cytogenetic analysis was carried out on 397 oocytes, and the steroid content of 104 corresponding FF was analyzed using high-pressure liquid chromatography. Ovarian stimulation was performed by clomiphene citrate and human menopausal gonadotropin (hMG) or by hMG combined with a gonadotropin-releasing hormone agonist (GnRH-a) pretreatment. RESULTS: Oocyte maturity was correlated with an increasing FF progestin content and a significant decrease of androstenedione (A) levels. Chromosomal analysis revealed 84 of all oocytes to be abnormal (polyploid or aneuploid and/or prematurely condensed chromosomes present). In this group, A levels and A to estradiol ratios were significantly higher. Although progestin levels were higher in GnRH-a/hMG cycles, the incidence of oocyte normality was not different between the two stimulation schemes. More abnormal oocytes were found in patients with good sperm morphology. CONCLUSIONS: Oocyte abnormality correlates with higher A levels in the corresponding FF. Oocyte fertilization is also determined by intrinsic oocytic factors other than maturity. 相似文献
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M. Guillemin H. Cachier C. Chini D. Dabill D. Dahmann F. Diebold A. Fischer H.-H. Fricke J. A. Groves R. Hebisch M. Houpillart G. Israël M. Mattenklott W. Moldenhauer J. P. Sandino C. Schlums E. Sutter E. Tucek 《International archives of occupational and environmental health》1997,70(3):161-172
Object: Diesel soot has been recognized as probably carcinogenic to humans. Elemental carbon (also called black carbon) in soot
is considered at the moment as the most significant surrogate to be measured for assessing the exposure to this pollutant.
Its analysis is done by combustion in an oven and determination of the CO2 formed, after elimination of the organic fraction of the soot by heating and/or by solvent extraction. The analysis allows
determination of both fractions of the soot: “elemental carbon” (EC) and organic carbon␣(OC). The sum of EC and OC is called
TC (total carbon). Method: An informal European coordination group organized two round robin tests on filter samples collected from diluted diesel
emissions. The first round (RRT1) was performed on 13 different samples analyzed by ten laboratories. The range of loading
was 2.5 to 150 μg/cm2 of EC. No evaluation of the precision within laboratories could be made since each laboratory gave only one result per sample.
Therefore a second round (RRT2) was organized with two samples and a blank filter sent in several portions to 11 laboratories.
It should be stressed that each laboratory used its own method and that no standardization was planned at this stage. Results: Results of RRT1 showed that the coefficient of variation between laboratories decreased with higher loading and was around
10% to 15% for EC above about 20 μg/cm2. Dispersion of the results varied and it appeared that the way OC is removed from the soot is probably the most important
factor of influence. The correlation between the laboratories was good as a whole but some systematic differences could be
detected. Besides the different techniques to remove the organic carbon, the pretreatment of the filter by HCl (either as
a vapor or as a solution) to remove the inorganic carbonates (potential interference sources), is probably also a significant
factor of influence in the dispersion of the results between laboratories. It is not yet clear from these results whether
the “environmental” laboratories give different results from the “occupational” laboratories, but it is clear that their objectives
differ since for the “environmentalists”, EC is not a specific marker of diesel immissions, in contrast to the “occupationalists”.
Conclusion: It can be concluded that, although significant differences exist between laboratories they can be attributed mainly to the
narrow distribution of the results within a single laboratory, and that the overall agreement of the results for EC and TC
is fairly good. These results obtained with pure diesel engine emissions, should be complemented by field samples, but they
have already achieved relevant findings in the performance of the procedures used to assess exposure to diesel soot.
Received: 30 December 1996 / Accepted: 21 February 1997 相似文献
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Bart D. Maes Wim Lemahieu Dirk Kuypers Pieter Evenepoel Willy Coosemans Jacques Pirenne Yves F. CH. Vanrenterghem 《American journal of transplantation》2002,2(10):989-992
Diarrhea is the most frequently reported adverse event in patients treated with mycophenolate mofetil. Twenty-six renal transplant patients on a mycophenolate mofetil-based immunosuppressive regime with persistent afebrile diarrhea were examined. Diarrhea caused a significant rise in FK-506 trough levels despite intake of stable doses, necessitating FK-506 dose reductions of 30% to obtain pre-diarrhea trough levels. In contrast, trough levels of cyclosporine A remained stable without dose adjustments. This suggests that absorption and/or metabolism is differentially altered for FK506 compared with cyclosporine A in patients with diarrhea. In nine patients mycophenolate mofetil was reduced or stopped because of persistent diarrhea without identifiable cause. This resulted in end-stage renal disease because of chronic rejection in two patients, and in acute rejection in two patients, all taking FK506 and steroids. Therefore, dose adjustments of FK506 in patients with diarrhea must be carefully monitored, especially when doses of mycophenolate mofetil are also reduced. 相似文献