Impact of 123 I-MIBG scintigraphy on clinical decision making in pheochromocytoma and paraganglioma

CONTEXT Cross sectional imaging with computed tomography (CT) or magnetic resonance imaging (MRI) is regarded as a first-choice modality for tumor localization in patients with pheochromocytoma and paraganglioma (PPGL). 123I-labeled metaiodobenzylguanidine (123I-MIBG) is widely used for functional imaging but the added diagnostic value is controversial. OBJECTIVE To establish the virtual impact of adding 123I-MIBG scintigraphy to CT or MRI on diagnosis and treatment of PPGL. DESIGN International multicenter retrospective study. INTERVENTION None. PATIENTS 236 unilateral adrenal, 18 bilateral adrenal, 48 unifocal extra-adrenal, 12 multifocal and 26 metastatic PPGL. MAIN OUTCOME MEASURES Patients underwent both anatomical imaging (CT and/or MRI) and 123I-MIBG scintigraphy. Local imaging reports were analyzed centrally by two independent observers who were blinded to the diagnosis. Imaging-based diagnoses determined by CT/MRI only, 123I-MIBG only, and CT/MRI combined with 123I-MIBG scintigraphy were compared with the correct diagnoses. RESULTS The rates of correct imaging-based diagnoses determined by CT/MRI only versus CT/MRI plus 123I-MIBG scintigraphy were similar: 89.4 versus 88.8%, respectively, (P=0.50). Adding 123I-MIBG scintigraphy to CT/MRI resulted in a correct change in the imaging-based diagnosis and ensuing virtual treatment in four cases (1.2%: two metastatic instead of non-metastatic, one multifocal instead of single, one unilateral instead of bilateral adrenal) at the cost of an incorrect change in seven cases (2.1%: four metastatic instead of non-metastatic, two multifocal instead of unifocal and one bilateral instead of unilateral adrenal). CONCLUSIONS For the initial localization of PPGL, the addition of 123I-MIBG scintigraphy to CT/MRI rarely improves the diagnostic accuracy at the cost of incorrect interpretation in others, even when 123I-MIBG scintigraphy is restricted to patients who are at risk for metastatic disease. In this setting, the impact of 123I-MIBG scintigraphy on clinical decision-making appears very limited

Pregnancy-related cardiac non-elective hospitalizations and pregnancy outcomes. A tertiary referral cardiac center experience

Background: Pregnant women with cardiovascular diseases (CVD) and their offspring are at higher risk of morbidity and mortality.Aims: To provide data on pregnancy outcomes among women with different types of CVD requiring non-elective cardiac hospitalization in a tertiary referral cardiac center.Methods: We identified all records of non-elective hospitalizations of pregnant women hospitalized between January 2009 through March 2018, at our institution — a tertiary referral cardiac center. The incidence and types of cardiac complications during pregnancy, as well as the pregnancy and offspring outcomes, were determined.Results: One hundred and sixty-one out of 328 pregnancy-related hospitalizations in 140 pregnancies were non-elective. Cardiac complications occurred in 62 (44%) pregnancies, with the most frequent being episodes of arrhythmia (22.1% pregnancies), followed by heart failure exacerbations (6.4% pregnancies). Maternal mortality reached 2.1% and affected only women with primary cardiomyopathies (CMP). Offspring mortality was 2.8%. Newborns of mothers with cardiac complications had significantly lower Apgar scores and gestational age at delivery, compared to mothers without cardiac complications.Conclusions: In our series mortality and morbidity among pregnant women with CVD hospitalizations were high. An unfavorable maternal outcome mainly affected women with CMP. Offspring of mothers with cardiovascular complications are prone to have a lower gestational age and Apgar score

The Evolution of Primate Short-Term Memory.

Short-term memory is implicated in a range of cognitive abilities and is critical for understanding primate cognitive evolution. To investigate the effects of phylogeny, ecology and sociality on short-term memory, we tested the largest and most diverse primate sample to date (421 non-human primates across 41 species) in an experimental delayed-response task. Our results confirm previous findings that longer delays decrease memory performance across species and taxa. Our analyses demonstrate a considerable contribution of phylogeny over ecological and social factors on the distribution of short-term memory performance in primates; closely related species had more similar short-term memory abilities. Overall, individuals in the branch of Hominoidea performed better compared to Cercopithecoidea, who in turn performed above Platyrrhini and Strepsirrhini. Interdependencies between phylogeny and socioecology of a given species presented an obstacle to disentangling the effects of each of these factors on the evolution of short-term memory capacity. However, this study offers an important step forward in understanding the interspecies and individual variation in short-term memory ability by providing the first phylogenetic reconstruction of this trait’s evolutionary history. The dataset constitutes a unique resource for studying the evolution of primate cognition and the role of short-term memory in other cognitive abilities.info:eu-repo/semantics/publishedVersio

The Evolution of Primate Short-Term Memory

Short-term memory is implicated in a range of cognitive abilities and is critical for understanding primate cognitive evolution. To investigate the effects of phylogeny, ecology and sociality on short-term memory, we tested the largest and most diverse primate sample to date (421 non-human primates across 41 species) in an experimental delayed-response task. Our results confirm previous findings that longer delays decrease memory performance across species and taxa. Our analyses demonstrate a considerable contribution of phylogeny over ecological and social factors on the distribution of short-term memory performance in primates; closely related species had more similar short-term memory abilities. Overall, individuals in the branch of Hominoidea performed better compared to Cercopithecoidea, who in turn performed above Platyrrhini and Strepsirrhini. Interdependencies between phylogeny and socioecology of a given species presented an obstacle to disentangling the effects of each of these factors on the evolution of short-term memory capacity. However, this study offers an important step forward in understanding the interspecies and individual variation in short-term memory ability by providing the first phylogenetic reconstruction of this trait’s evolutionary history. The dataset constitutes a unique resource for studying the evolution of primate cognition and the role of short-term memory in other cognitive abilities

Potencjał roślin energetycznych w przestrzeni ogrodowej

Celem pracy jest dokonanie wyboru gatunków roślin energetycznych, które oprócz funkcji użytkowej będą wykazywały możliwości aranżacyjne w ogrodach przydomowych, położonych na obszarach wiejskich. Praca ma charakter przeglądowy i opiera się o własną dokumentację fotograficzną. W ramach analizy zapoznano się z dostępną ofertą rynkową produktów wykonanych z wikliny (Salix purpurea) – jednego z głównych surowców, wykorzystywanych w aranżacji wnętrz ogrodowych. Spośród wielu dostępnych gatunków i odmian roślin użytkowanych jako rośliny energetyczne wytypowano: słonecznik bulwiasty (Helianthus tuberosus), miskant (Miscanthus sp.) oraz wierzbę (Salix sp.). Rośliny energetyczne są łatwo dostępnym źródłem energii, które nie wymagają nadmiernych nakładów inwestycyjnych. Sadzenie tych roślin stwarza miejsce bytowania zwierząt, zatem wpływa na wzrost bioróżnorodności, jednocześnie podnosząc estetykę otoczenia. Surowce mogą stwarzać rozliczne możliwości kompozycyjne, wykorzystywane jako elementy małej architektury ogrodowej. Uprawa roślin energetycznych wpisuje się w trend ekologiczny oraz poprawia mikroklimat w ogrodzie

Plant-Based Solutions for Non-Productive Sites Useful in the Management of Dry Land

The article presents an overview of research conducted in recent years, i.e., from 2004 until now. The study has been prompted by the threat of drought over large land areas which, as a result of current climate change, may lead to desertification in dry and hot regions of the world. For the same reason, large areas of farmland are affected by drought stress. At the same time, rising air temperatures result in a significant intensification of evaporation and a gradual increase in soil salinity. This applies in particular to acres of farmland, forested areas, and green areas of cities, as well as degraded land or brownfields. As the crop stability is threatened, the food base of the world’s population is at risk and, additionally, in areas of industrial districts, people’s health is in decline. Due to these multistress conditions for plant growth, we propose a review of the current literature which addresses the possibility of counteracting these unfavorable phenomena through the appropriate selection of plant species and, when only applicable, also through specific agroecological treatments. A selection of herbaceous and woody plants useful for cultivation on saline marginal lands was proposed

Study of dust deposition and temperature impact on solar photovoltaic module

This work investigates the effect of the dust deposition and temperature on the photovoltaic module working under varying environmental conditions. The impact of the module temperature caused by the dust deposition, as well as direct impact caused by the dust particle absorption, scattering and reflectance on module performance, has been analysed. Presented results showed that dust deposition even in desert free country Poland influences the module temperature and power output significant. The estimated join effect of dust deposition and temperature increase, on power loss after three-four days of natural dust exposure in the city environment, was about 0.32 and 0.37 point of percentage for the selected sunny and cloudy days while evaluated PV system efficiency was in the range 13.37-14.14%

Study of dust deposition and temperature impact on solar photovoltaic module

This work investigates the effect of the dust deposition and temperature on the photovoltaic module working under varying environmental conditions. The impact of the module temperature caused by the dust deposition, as well as direct impact caused by the dust particle absorption, scattering and reflectance on module performance, has been analysed. Presented results showed that dust deposition even in desert free country Poland influences the module temperature and power output significant. The estimated join effect of dust deposition and temperature increase, on power loss after three-four days of natural dust exposure in the city environment, was about 0.32 and 0.37 point of percentage for the selected sunny and cloudy days while evaluated PV system efficiency was in the range 13.37-14.14%

Plasma methoxytyramine: clinical utility with metanephrines for diagnosis of pheochromocytoma and paraganglioma

CONTEXT: Measurements of plasma methoxytyramine, the O-methylated dopamine metabolite, are useful for detecting rare dopamine-producing pheochromocytomas and paragangliomas (PPGLs) and head and neck paragangliomas (HNPGLs), but utility for screening beyond that achieved using standard measurements of normetanephrine and metanephrine is unclear. OBJECTIVE: Evaluation of the additional utility of methoxytyramine compared to plasma normetanephrine and metanephrine for diagnosis of PPGLs and HNPGLs. DESIGN: Comparative prospective study. METHODS: Comparison of mass spectrometric-based measurements of plasma methoxytyramine, normetanephrine and metanephrine in 1963 patients tested for PPGLs at six tertiary medical centers according to reference intervals verified in 423 normotensive and hypertensive volunteers. RESULTS: Of the screened patients, 213 had PPGLs and 38 HNPGLs. Using an upper cut-off of 0.10 nmol/L for methoxytyramine, 0.45 nmol/L for metanephrine and age-specific upper cut-offs for normetanephrine, diagnostic sensitivity with the addition of methoxytyramine increased from 97.2% to 98.6% for patients with PPGLs and from 22.1% to 50.0% for patients with HNPGLs, with a small decrease in specificity from 95.9% to 95.1%. Addition of methoxytyramine did not significantly alter areas under receiver operating characteristic curves for patients with PPGLs (0.984 vs 0.991), but did increase (P < 0.05) areas for patients with HNPGLs (0.627 vs 0.801). Addition of methoxytyramine also increased the proportion of patients with PPGLs who showed highly positive predictive elevations of multiple metabolites (70.9% vs 49.3%). CONCLUSIONS: While the benefit of additional measurements of plasma methoxytyramine for the detection of PPGLs is modest, the measurements do assist with positive confirmation of disease and are useful for the detection of HNPGLs

Optimized procedures for testing plasma metanephrines in patients on hemodialysis

Diagnosis of pheochromocytomas and paragangliomas in patients receiving hemodialysis is troublesome. The aim of the study was to establish optimal conditions for blood sampling for mass spectrometric measurements of normetanephrine, metanephrine and 3-methoxytyramine in patients on hemodialysis and specific reference intervals for plasma metanephrines under the most optimal sampling conditions. Blood was sampled before and near the end of dialysis, including different sampling sites in 170 patients on hemodialysis. Plasma normetanephrine concentrations were lower (P < 0.0001) and metanephrine concentrations higher (P < 0.0001) in shunt than in venous blood, with no differences for 3-methoxytyramine. Normetanephrine, metanephrine and 3-methoxytyramine concentrations in shunt and venous blood were lower (P < 0.0001) near the end than before hemodialysis. Upper cut-offs for normetanephrine were 34% lower when the blood was drawn from the shunt and near the end of hemodialysis compared to blood drawn before hemodialysis. This study establishes optimal sampling conditions using blood from the dialysis shunt near the end of hemodialysis with optimal reference intervals for plasma metanephrines for the diagnosis of pheochromocytomas/paragangliomas among patients on hemodialysis