CT-measured pulmonary artery diameter as an independent predictor of pulmonary hypertension in cystic fibrosis

Purpose: The role of computed tomography (CT) scan, as a promising prognostic imaging modality in cystic fibrosis(CF), has been widely investigated, focusing on parenchymal abnormalities. The aim of the present study was to evaluate the diagnostic performance of thoracic vascular parameters on CT to detect pulmonary hypertension (PH). Material and methods: CF patients who contemporaneously underwent CT and echocardiography were retrospectively enrolled. Baseline characteristics in addition to pulmonary artery diameter (PAD) and pulmonary to aortic (PA/A) ratio were compared between cohorts with and without PH, based on the results of echocardiography separately in paediatric patients (< 18) and adults (≥ 18). Results: Of a total 119 CF patients, 39 (32.8%) had PH (paediatric: 23/78, 29.5%, adult: 16/41, 39%). In paediatric CF patients, mean age, HCo3, PCo2, and pulmonary artery diameter (PAD) were significantly higher in the PH group compared to the non-PH group. Mean pulmo however, only PAD remained as the independent predictor of PH based on multivariate analysis (overall: 22.86 mm [±3.86] vs. 18.43 mm [±4.72], p = 0.005, paediatric patients: 22.63 mm [±4.4] vs. 17.10 mm [±4.64], p = 0.03). Using a cut off of 19.25 mm, the diagnostic performance of PAD to detect PH was found to be as follows: sensitivity = 82%, specificity = 70%, and accuracy = 73.1%. No significant difference was demonstrated in PAD between PH and non-PH groups in adults with CF (23.19 [±3.60] vs. 21.34 [±3.49], p = 0.7). Conclusions: In CF patients, PAD revealed an age-dependent performance to detect PH. PAD can be applied to predict pulmonary hypertension in paediatric CF patients and may be recommended to be routinely measured on follow-up chest CT scan in childhood CF

The Relation between Awareness of Cancer Diagnosis and Spiritual Health among Cancer Patients

Introduction: Disclosure of cancer diagnosis is one the main challenges in caring of patients with cancer since it may have negative effects on the spiritual health of patients. No study has ever been performed in Iran to investigate the relationship between awareness of cancer diagnosis and spiritual health in cancer patients. Therefore, the present study aimed to review the effects of awareness of cancer on spiritual health in patients with cancer. Methods: This was a descriptive-comparative study conducted in Shahid Ghazi Tabatabaei University Hospital in 2009. The subjects included 150 patients aware of their cancer diagnosis and 150 unaware patients. The patients were selected through convenient sampling method. Using a questionnaire, the patient's spiritual health was assessed. Data analysis was conducted in SPSS17 using descriptive and inferential statistics. Results: Results showed the mean (SD) of spiritual health among aware and unaware patients to be 75.1 (3.8) and 75.4 (3.9), respectively. Statistically, there was no significant difference between the spiritual health of the two groups (p = 0.96). Conclusion: These findings showed that awareness of cancer diagnosis had no effects on spiritual health of patients. It is not surprising considering Iranian culture. However, confirmation of this finding requires further studies

Breast Incidental Lesions at 18 F FDG PET/CT: Diagnostic Performance of PET-derived Metabolic Parameters

Background: Breast incidental lesion at 18 F FDG PET/CT are occasionally encountered in cancer patients, which may represent a second primary malignancy. The aim of the present study was to investigate the diagnostic performance of PET metabolic parameters to characterize breast incidentaloma.Materials and Methods: All the images of patients with cancers other than breast with breast incidental lesion underwent PET/CT scan at Masih Daneshvari Hospital between May 2012 and May 2016 were retrieved and reviewed. SUVmax, SUVmean, MTV and TLG in addition to associated morphologic features on CT and demographics were recorded and correlated with final diagnosis defined by histophatologic confirmation or an at least 1-year clinical formal follow up.Results: Of a total 58 from 51 patients (51/5029, 1.01%), 10 (19.60%) were histopathologically verified as second primary breast cancers. There was a statistically significant difference in SUVmax, SUVmean, MTV and TLG between benign and malignant group (1.64 vs. 5.32 (p=0.009), 1.34 vs. 3.69 (p=0.027), 0.96 vs. 2.62 (p=0.035), 1.54 vs 8.89 (p=0.006). Using cut off 2, 1.35, 1.16 and 1.75, sensitivity and specificity of SUVmax, SUVmean, MTV and TLG were calculated as 77% and 62%, 92% and 66.5%, 77% and 75% 77% and 67%, respectively.Conclusion: Despite a significantly higher value in malignant breast incidental lesion, PET-derivative metabolic parameters provided only modest sensitivity and specificity and hence may not be considered as the sole criteria for risk stratification in this clinical setting

Diagnostic Performance of F-18 FDG PET/CT in Patients with Cancer of Unknown Primary: Additional Benefit over CT-Based Conventional Work up

Background: In the era of well-developed site-specific treatment strategies in cancer, identification of occult primary is of paramount importance in CUP patients. Furthermore, exact determination of the extent of the disease may help in optimizing treatment planning. The aim of the present study was to investigate additional value of F-18 FDG PET/CT in patients with cancer of unknown primary (CUP) as an appropriate imaging tool in early phase of initial standard work up.Materials and Methods: Sixty-two newly diagnosed CUP patients with inconclusive diagnostic CT scan of chest, abdomen and pelvis referring for F-18 FDG PET/CT were enrolled in this study. Standard of reference was defined as histopathology, other diagnostic procedures and a 3-month formal clinical follow up. The results of PET/CT were categorized as suggestion for primary site and additional metastasis and classified as true positive, false positive, false negative and true negative. The impact of additional metastasis revealed by F-18 FDG PET/CT on treatment planning and the time contribution of F-18 FDG PET/CT in diagnostic pathway was investigated.Results: Sixty-two patients with mean age of 62 (30 men, 32 women), PET/CT correctly identified primary origin in 32% with false positive rate of 14.8%. No primary lesion was detected after negative PET/CT according to standard of reference. Sensitivity, Specificity and accuracy were 100%, 78% and 85%, respectively. Additional metastatic site was found in 56% with 22% impact on treatment planning. Time contribution for PET/CT was 10% of total diagnostic pathway.Conclusion: Providing higher detection rate of primary origin with excellent diagnostic performance, shortening the diagnostic pathway and improving treatment planning, F-18 FDG PET/CT may play a major role in diagnostic work up of CUP patients and may be recommended as an alternative imaging tool in early phase of investigation

Association of FSH receptor promoter’s polymorphisms with IVF-failure in Iranian women

Background: Follicle-Stimulating Hormone Receptor (FSHR) gene shows five Single Nucleotide Polymorphisms (SNPs) in the promoter region at positions -29, -37, - 114, -123 and -138 that have been reported to be associated with higher levels of FSH and various ovarian responses to FSH in IVF (In-vitro fertilization) treatment at different populations.  Hence, they are important regulators of hormone activity at the target level in IVF process. This study was performed to investigate the association between FSHR gene polymorphisms and IVF failure in Iranian women.Methods: SNPs in the promoter region of FSHR gene were analyzed by PCR and direct sequencing technique in 90 women in three equally sized groups of IVF failure, IVF success and normal fertile women, using genomic DNA extracted from white blood cells.Results: No significant differences were found in allelic variants frequency and genotype distribution between each category of subjects when analyzing the FSHR SNPs in the promoter region (p-value >0.05).   However, analysis of the data revealed that the subjects with A/A genotype at the –29 position received higher amount of exogenous FSH for ovulation induction compared to G/G genotypes.Conclusions: These results indicate that the FSHR SNP at position –29 may influence sensitivity of the FSHR to FSH for ovulation induction in IVF treatment.  It may be concluded that the A/A genotype at position –29 is associated with poor ovarian response to FSH so that subjects with A/A genotype at the –29 position may require higher doses of exogenous FSH for ovulation induction during IVF process

Silica nanoparticles as a highly efficient catalyst for the one-pot synthesis of sterically congested 2-(dibenzylamino)-2-aryl acetamide derivatives from by phthaldehyde isomers, isocyanides and dibenzylamine

A green and efficient method for the preparation of 2-(dibenzylamino)-2-aryl acetamide derivatives via a three-component reaction of an isocyanide, dibenzylamine and a phthalaldehyde derivative in the presence of silica nanoparticles (silica NPs, ca. 42 nm) as a catalyst under solvent free conditions at room temperature is described. The ease of work-up, green chemistry conditions and high yields of the products make this procedure a useful addition to modern synthetic methods. The silica nanoparticles that used in this reaction as a catalyst were prepared by thermal decomposition of rice hulls. Simple, green and cheap method for the preparation of the nanocatalyst represents a major advantage for this process. The structures of these compounds were confirmed by IR, 1H and 13C NMR spectroscopy. KEY WORDS: Silica nanoparticles, Nanocatalyst, Isocyanide, Phthalaldehyde Bull. Chem. Soc. Ethiop. 2016, 30(3), 413-420DOI: http://dx.doi.org/10.4314/bcse.v30i3.

Brain-Included 18F FDG PET/CT Acquisition Protocol: Cancer-Specified Clinical Impact of Newly-Diagnosed Brain Metastasis in Extra-Cerebral Cancer Patients

Background: Evolution of individualized radiosurgical therapeutic methods for brain metastasis as an ominous prognostic finding may encourage a more extensive application of neuroimaging in patients with extracerebral cancer. The aim of the present study was to investigate the added value of brain-included 18 F FDG PET/CT acquisition protocol based on primary cancer type and clinical indication.Materials and Methods: A retrospective review was performed on 3945 18 F FDG PET/CT reports of patients with extra-cerebral cancer underwent brain-included PET/CT study. Cerebral lesions suggestive of brain metastasis were subsequently verified by MRI, MRI+MRS, surgical pathology and a 1-year clinical formal follow up. The detection rate of new brain metastasis and related impact on disease status were then investigated in each cancer type based on clinical indication.Results: Of a total 3933 eligible patients, 44 (1.12%) were finally verified to have new cerebral metastasis. The most common primary sources were lung cancer (19/385, 4.93%), cancer of unknown primary (CUP) (5/168, 2.97%) and breast cancer (8/468, 1.71%). The most common clinical indications were initial staging (17/44, 43.1%) and restaging (19/44, 36.4%). Change in disease status occurred in 12 out of 44 patients (27.3%), more frequently occurred in lung cancer (n=4), in all indications and breast (n=3) cancers at restaging (n=7, 43.8%).Conclusion: PET/CT acquisition protocol study may be best optimized based on the type of primary cancer and timing of evaluation. Brain-included field of view may be recommended for lung cancer regardless the clinical indication, cancer of unknown primary and breast cancer at restaging

A Comparative Investigation of Political Thoughts of Davari and Soroush Regarding the West

After the victory of the Islamic Revolution of Iran, scholars and thinkers encountered new scientific conditions, modern political ideas and newly established time and ground, and each, responding to these new upheavals which was the governance and fulfilment of Islamic commandments in all political, social, cultural and economic fields, presented ideas appropriate to their thought constellation. Reza Davari as a Fardidian thinker, following the ideas of the famous German philosopher, Martin Heidegger, criticizes the West philosophically and phenomenologically and knows the only redemptive path for Iranians as leaving the West as an integrated whole and criticizes modernity in a severe way. Contrary to this uncompromising approach to the West, another approach, particularly in the second and third decades of the Islamic Revolution gradually appeared which practiced sympathetic approaches to the West and Abdul Karim Soroush as the forerunner of this approach, tried to pave that path for establishing modernism by an epistemological reading of religion. In the present article, it has been tried to discuss and compare the ideas and thoughts of Davari and Soroush to the West. DOI: 10.5901/mjss.2014.v5n7p55

Energy system transition pathways to meet the global electricity demand for ambitious climate targets and cost competitiveness.

This study presents a novel energy system modelling approach for analysis and comparison of global energy transition pathways for decarbonisation of the electricity sector. The results of the International Energy Agency (IEA), and the Teske/DLR scenarios are each reproduced. Additionally, five new energy transition trajectories, called LUT, are presented. The research examines the feasibility of each scenario across nine major regions in 5-year intervals, from 2015 to 2050, under a uniform modelling environment with identical technical and financial assumptions. The main differences between the energy transition paths are identified across: (1) the average electricity generation costs; (2) energy diversity; (3) system flexibility; (4) energy security; and, (5) transition dynamics. All LUT and Teske/DLR scenarios are transitioned to zero CO2 emissions and a 100% renewable energy system by 2050 at the latest. Results reveal that the LUT scenarios are the least-cost pathways, while the Teske/DLR scenarios are centred around energy diversity with slightly higher LCOE of around 10-20%. The IEA shares similarities with the Teske/DLR scenarios in terms of energy diversity yet depends on continued use of fossil fuels with carbon capture and storage, and nuclear power. The IEA scenario based on current governmental policies present a worst-case situation regarding CO2 emissions reduction, climate change and overall system costs