81 research outputs found
Corneal Confocal Microscopy Detects Small Fibre Neuropathy in Patients with Upper Gastrointestinal Cancer and Nerve Regeneration in Chemotherapy Induced Peripheral Neuropathy.
Published onlineThere are multiple neurological complications of cancer and its treatment. This study assessed the utility of the novel non-invasive ophthalmic technique of corneal confocal microscopy in identifying neuropathy in patients with upper gastrointestinal cancer before and after platinum based chemotherapy. In this study, 21 subjects with upper gastrointestinal (oesophageal or gastric) cancer and 21 healthy control subjects underwent assessment of neuropathy using the neuropathy disability score, quantitative sensory testing for vibration perception threshold, warm and cold sensation thresholds, cold and heat induced pain thresholds, nerve conduction studies and corneal confocal microscopy. Patients with gastro-oesophageal cancer had higher heat induced pain (P = 0.04) and warm sensation (P = 0.03) thresholds with a significantly reduced sural sensory (P<0.01) and peroneal motor (P<0.01) nerve conduction velocity, corneal nerve fibre density (CNFD), nerve branch density (CNBD) and nerve fibre length (CNFL) (P<0.0001). Furthermore, CNFD correlated significantly with the time from presentation with symptoms to commencing chemotherapy (r = -0.54, P = 0.02), and CNFL (r = -0.8, P<0.0001) and CNBD (r = 0.63, P = 0.003) were related to the severity of lymph node involvement. After the 3rd cycle of chemotherapy, there was no change in any measure of neuropathy, except for a significant increase in CNFL (P = 0.003). Corneal confocal microscopy detects a small fibre neuropathy in this cohort of patients with upper gastrointestinal cancer, which was related to disease severity. Furthermore, the increase in CNFL after the chemotherapy may indicate nerve regeneration
Characterizing decoherence rates of a superconducting qubit by direct microwave scattering
We experimentally investigate a superconducting qubit coupled to the end of an open transmission line, in a regime where the qubit decay rates to the transmission line and to its own environment are comparable. We perform measurements of coherent and incoherent scattering, on- and off-resonant fluorescence, and time-resolved dynamics to determine the decay and decoherence rates of the qubit. In particular, these measurements let us discriminate between non-radiative decay and pure dephasing. We combine and contrast results across all methods and find consistent values for the extracted rates. The results show that the pure dephasing rate is one order of magnitude smaller than the non-radiative decay rate for our qubit. Our results indicate a pathway to benchmark decoherence rates of superconducting qubits in a resonator-free setting
Automated Quantification of Neuropad Improves Its Diagnostic Ability in Patients with Diabetic Neuropathy.
PublishedResearch Support, N.I.H., ExtramuralResearch Support, Non-U.S. Gov'tNeuropad is currently a categorical visual screening test that identifies diabetic patients at risk of foot ulceration. The diagnostic performance of Neuropad was compared between the categorical and continuous (image-analysis (Sudometrics)) outputs to diagnose diabetic peripheral neuropathy (DPN). 110 subjects with type 1 and 2 diabetes underwent assessment with Neuropad, Neuropathy Disability Score (NDS), peroneal motor nerve conduction velocity (PMNCV), sural nerve action potential (SNAP), Deep Breathing-Heart Rate Variability (DB-HRV), intraepidermal nerve fibre density (IENFD), and corneal confocal microscopy (CCM). 46/110 patients had DPN according to the Toronto consensus. The continuous output displayed high sensitivity and specificity for DB-HRV (91%, 83%), CNFD (88%, 78%), and SNAP (88%, 83%), whereas the categorical output showed high sensitivity but low specificity. The optimal cut-off points were 90% for the detection of autonomic dysfunction (DB-HRV) and 80% for small fibre neuropathy (CNFD). The diagnostic efficacy of the continuous Neuropad output for abnormal DB-HRV (AUC: 91%, P = 0.0003) and CNFD (AUC: 82%, P = 0.01) was better than for PMNCV (AUC: 60%). The categorical output showed no significant difference in diagnostic efficacy for these same measures. An image analysis algorithm generating a continuous output (Sudometrics) improved the diagnostic ability of Neuropad, particularly in detecting autonomic and small fibre neuropathy.National Institute of Health (NIH)Juvenile Diabetes Research Foundation (JDRF
Preliminary tests of innovative thin silicon detectors for beam monitoring in particle therapy.
Palatal development of preterm and low birthweight infants compared to term infants – What do we know? Part 2: The palate of the preterm/low birthweight infant
BACKGROUND: Well-designed clinical studies on the palatal development in preterm and low birthweight infants are desirable because the literature is characterized by contradictory results. It could be shown that knowledge about 'normal' palatal development is still weak as well (Part 1). The objective of this review is therefore to contribute a fundamental analysis of methodologies, confounding factors, and outcomes of studies on palatal development in preterm and low birthweight infants. METHODS: An electronic literature search as well as hand searches were performed based on Cochrane search strategies including sources of more than a century in English, German, and French. Original data were recalculated from studies which primarily dealt with both preterm and term infants. The extracted data, especially those from non-English paper sources, were provided unfiltered for comparison. RESULTS: Seventy-eight out of 155 included articles were analyzed for palatal morphology of preterm infants. Intubation, feeding tubes, feeding mode, tube characteristics, restriction of oral functions, kind of diet, cranial form and birthweight were seen as causes contributing to altered palatal morphology. Changes associated with intubation concern length, depth, width, asymmetry, crossbite, and contour of the palate. The phenomenon 'grooving' has also been described as a complication associated with oral intubation. However, this phenomenon suffers from lack of a clear-cut definition. Head flattening, pressure from the oral tube, pathologic or impaired tongue function, and broadening of the alveolar ridges adjacent to the tube have been raised as causes of 'grooving'. Metrically, the palates of intubated preterm infants remain narrower, which has been examined up to the age of the late mixed dentition. CONCLUSION: There is no evidence that would justify the exclusion of any of the raised causes contributing to palatal alteration. Thus, early orthodontic and logopedic control of formerly orally intubated preterm infants is recommended, as opposed to non-intubated infants. From the orthodontic point of view, nasal intubation should be favored. The role that palatal protection plates and pressure-dispersing pads for the head have in palatal development remains unclear
Corneal confocal microscopy detects improvements in small nerve fibres in subjects with latent autoimmune diabetes in adults with enhanced glycaemic control
Thermal enhancement effect on chemo-radiation of Glioblastoma multiform
Background: Hyperthermia plays a significant role in the chemo-radiotherapy effect in different malignancies. In this research, we treated Glioblastoma multform (GBM) patents with hyperthermia (HT) along with the chemoradiaton, in order to evaluate HT efficacy in terms of tumor volume changes, survival tme, and probability. Materials and Methods: Thirty-eight GBM patents were distributed into two groups identfied as chemoradiaton (CRT), and also CRT plus HT (CRHT). The Karnofsky Performance Status Scale (KPS) was done before, immediately and three months after treatments. Capacitve hyperthermia device was used at frequency of 13.56 MHz (Celsius 42+ GmbH, Germany) for HT one hour before the radiotherapy for 10-12 sessions. Patents in both groups underwent MR imaging (1.5 Tesla) before, 3 and 6 months after the treatments. Thermal enhancement factors (TEF) were atained in terms of clinical target volume changes, TEF(CTV), and survival probability (SP) or TEF(SP). Results: Age ranges were from 27-73 years (Mean=50) and 27-65 years (Mean=50) for CRT and CRHT groups, respectvely. For 53 and 47 of cases biopsy and partal resecton were accomplished in both groups, respectvely. Means and standard deviatons of tumor volumes were 135.42±92.5 and 58.4±104.1cm3before treatment in CRT and CRHT groups, respectvely, with no significant difference (P= 0.2). TEF(CTV) value was atained to be as 1.54 and 1.70 for three and six months after treatments, respectvely, TEF(SP) was also equal to the 1.90. Conclusion: HT enhanced the chemoradiaton effects throughout the patent survival probability and KPS. TEF may reflect the hyperthermia efficacy for a given radiaton dose. © 2020 Novin Medical Radiation Institute. All rights reserved
Palatal development of preterm and low birthweight infants compared to term infants – What do we know? Part 3: Discussion and Conclusion
BACKGROUND: It has been hypothesized that prematurity and adjunctive neonatal care is 'a priori' a risk for disturbances of palatal and orofacial development which increases the need for later orthodontic or orthognathic treatment. As results on late consequences of prematurity are consistently contradictory, the necessity exists for a fundamental analysis of existing methodologies, confounding factors, and outcomes of studies on palatal development in preterm and low birthweight infants. METHOD: A search of the literature was conducted based on Cochrane search strategies including sources in English, German, and French. Original data were recalculated from studies which primarily dealt with both preterm and term infants. The extracted data, especially those from non-English paper sources, were provided unfiltered in tables for comparison (Parts 1 and 2). RESULTS: Morphology assessment of the infant palate is subject to non-standardized visual and metrical measurements. Most methodologies are inadequate for measuring a three-dimensional shape. Several confounding factors were identified as causes contributing to disturbances of palatal and orofacial development. CONCLUSION: Taking into account the abovementioned shortcomings, the following conclusions may be drawn for practitioners and prospective investigators of clinical studies. 1) The lack of uniformity in the anatomical nomenclature of the infant's palate underlines the need for a uniform definition. 2) Metrically, non-intubated preterm infants do not exhibit different palatal width or height compared to matched term infants up to the corrected age of three months. Beyond that age, no data on the subject are currently available. 3) Oral intubation does not invariably alter palatal morphology of preterm and low birthweight infants. 4) The findings on palatal grooving, height, and asymmetry as a consequence of orotracheal intubation up to the age of 11 years are inconsistent. 5) Metrically, the palates of orally intubated infants remain narrower posteriorly, beginning at the second deciduous molar, until the age of 11 years. Beyond that age, no data on the subject are currently available. 6) There is a definite need for further, especially metrical, longitudinal and controlled trials on palatal morphology of preterm and low birthweight infants with reliable measuring techniques. 7) None of the raised confounding factors for developmental disturbances may be excluded until evident results are presented. Thus, early orthodontic and logopedic control of formerly premature infants is recommended up to the late mixed dentition stage
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