Minimalnie inwazyjna paratyroidektomia pod kontrolą obrazowania radioizotopowego — porównanie niskich i wysokich dawek Tc-99m-MIBI

Introduction: Surgery remains the most effective treatment for primary hyperparathyroidism (PHPT). Minimally invasive radioguided parathyroidectomy (MIRP) is a common technique for detecting and excising abnormal parathyroid glands. The aim of this study was to compare injections of low-dose and high-dose (99m) Tc methoxy isobutyl isonitrile (MIBI) for intraoperative localisation of parathyroid adenomas by means of a gamma probe in patients with primary hyperparathyroidism (PHPT). Material and methods: Thirty patients with PHPT and a preoperative diagnosis of parathyroid adenoma were enrolled between 2010 and 2012. They were considered as Group B and underwent MIRP using 5 mCi Tc-99m MIBI, and their perioperative data were compared with twenty patients treated with conventional 20 mCi Tc-99m MIBI previously (Group A). Results: Group A was made up of 20 patients (mean age, 41.55 years; 14 women and 6 men), and group B included 30 patients (mean age, 40.43 years; 19 women and 11 men). The mean serum parathyroid hormone (PTH) and calcium values were recorded pre- and postoperatively. The mean follow-up period for the patients in the two groups was 18.4 and 16.5 months, respectively. Pre-operative evaluation demonstrated that the groups were statistically similar. Intraoperative data and success rate of surgery showed no difference between the two groups. No significant complication was detected after surgeries and no recurrence happened in either of the two groups during the follow-up period. Conclusions: A new protocol of MIRP using low doses of Tc-99m-MIBI resulted in an excellent success rate. Comparing results of the study, we conclude that low-dose Tc-99m-MIBI may be preferred for identification of parathyroid adenomas intraoperatively by means of a gamma probe in PHPT patients because it appears to be as effective as high-dose Tc-99m-MIBI.Wstęp: Najbardziej skutecznym leczeniem pierwotnej nadczynności przytarczyc (PHPT, primary hyperparathyroidism) nadal pozostaje zabieg chirurgiczny. Minimalnie inwazyjna paratyroidektomia z lokalizacją radioizotopową (MIRP, minimally invasive radioguided parathyroidectomy) jest techniką często stosowaną do wykrywania i wycinania nieprawidłowych przytarczyc. Badanie przeprowadzono w celu porównania małej i dużej dawki (99m) Tc metoksy-izobutylu-izonitrylu (MIBI) podawanych w celu śródoperacyjnej lokalizacji gruczolaków przytarczyc za pomocą sondy gamma u chorych z pierwotną nadczynnością przytarczyc (PHPT, primary hyperparathyroidism). Materiał i metody: W latach 2010–2012 do badania włączono 30 chorych z PHPT i przedoperacyjnym rozpoznaniem gruczolaka przytarczyc. W tej grupie chorych określonej jako grupa B wykonano MIRP po podaniu 5 mCi Tc-99m MIBI, a dane okołooperacyjne tych chorych porównano z danymi 20 pacjentów, u których zastosowano konwencjonalną dawkę 20 mCi Tc-99m MIBI (grupa A). Wyniki: Grupa A składała się z 20 chorych (średnia wieku 41,55 r.; 14 kobiet i 6 mężczyzn), a grupę B tworzyło 30 chorych (średnia wieku 40,43 r.; 19 kobiet i 11 mężczyzn). Zmierzono przed- i pooperacyjne stężenia w surowicy parathormonu (PTH, pathyroid hormone) i wapnia. Średni okres obserwacji chorych w grupach A i B wynosił odpowiednio 18,4 i 16,5 miesiąca. Ocena przedoperacyjna wykazała, że grupy nie różniły się statystycznie między sobą. Również dane śródoperacyjne odsetek zabiegów zakończonych powodzeniem były podobne w obu grupach. W żadnej z grup nie stwierdzono istotnych powikłań pozabiegowych ani nawrotu w okresie obserwacji. Wnioski: Nowy protokół MIRP z użyciem małych dawek Tc-99m-MIBI wiązał się z bardzo wysokim odsetkiem pomyślnych zabiegów. Porównanie wyników uzyskanych w badaniu pozwala sformułować wniosek, że do śródoperacyjnego identyfikowania za pomocą sondy gamma gruczolaków nadnercza u chorych z PHPT mogą być preferowane małe dawki Tc-99m-MIBI, ponieważ są równie skuteczne jak duże dawki Tc-99m-MIBI

Limnological of Bukan Dam Reservoir

In order to limnological study of Bukan Dam reservoir, sampling was performed monthly from determined sampling sites from April 2013 to March 2014. Sampling was conducted in reservoir lake by a PVC pipe with 2.25 m length and 5 cm diameter by columnar method. Besides, in more dipper (>5 m) sites, sampling conducted from bottom to surface with 1-m intervals (layer sampling) by a 2-liter Ruttner type sampler. In rivers due to water flow sampling was conducted by a scaled measure. Phytoplankton sampling was performed by 1-liter bottles. Zooplankton was sampled by filtering of 30 L through 55- micron plankton net. These samples were then transferred into bottles and sampling date and the name of station were attached on the bottles. Then, the samples were fixed immediately and transported to laboratory. It should be mentioned some physical parameters were determined in situ. Also, a 2-liter and another 1-liter water were collected to determine chlorophyll a and chemical factors respectively. Samples were preserved in dark and cold place for a week. The upper layers (without phytoplankton) were removed and the lower layer (with phytoplankton) was sampled into 5-ml chambers. The enumeration and identification was performed by a Nikon TS100 inverted microscope with ×400 (Phytoplankton) and ×200 (Zooplankton) magnification according to Utermohl (1958) method. About 50 fields were enumerated for each sample. The comparison of physicochemical and biological factors with standard criterion indicated that the presence of a fertile plain, agricultural growth, drought and higher water demand in recent years, as well as, higher population density, the Saghez city which is the main source of pollution in Bukan dam reservoir has caused that Bukan dam is in the transit state from mesotrophy to eutrophy. The results of the present study suggested that higher trophy in Bukan dam reservoir together with algal high density has negatively affected the Fish life and has reduced the stock in the lake. However, complementary studies should be performed prior to releasing. In this way the problems of other ecosystems should be prevented

Monitoring of fisheries resources in artificial reefs in east of Kish Island waters

Artificial reefs are manmade materials deployed under water in order to improve environment and increase the exploitation of fishing area. Usage of artificial technic has developed due to increase of world population and need to supply of protein, aim to restoring of natural specially rehabilitation of demersal fishes. It has effected to increase the production in order sustainable exploitation. Coasts and Islands have destruction due to over harvesting from ecosystems and other activities by humans and natural, these caused many aquatic as demersal fishes has endangered in Persian Gulf and Oman Sea. The artificial reef is one way or method that can improve the environment and restore the aquatic. Iranian fisheries has established an artificial reefs area in west of Kish Island. This area has studied during one year, Data of assembled fishes and physical sampling were collected in seasonal during spring, summer, autumn and wintered. There were tow treatment for sampling as artificial reefs site and a control site. Collected data has analyzed and evaluated by SPSS and Exel. The results showed that there was significant difference between the sites and assembled fishes in artificial reefs were more than control site. Consequently the artificial reefs can be a tool and technic to improve the marine environment and increase the production of fishes, especially the demersal fishes

The fifth developing plan of Iranian Fisheries Research Institute

Accurate scientific and practical plan for achieving the goals of the Islamic Republic of Iran within the framework of Vision development 1404, is the infrastructure achieving sustainable development of the country. Order to achieve the above mentioned objectives and in order to the comprehensive development plans in the country, Iranian fisheries research organization adjust the fifth developing plan for support of executive related departments in country with mobilization a large number researchers consists of several working groups of ifro affiliated research centers. The fifth developing plan consist of three chapters for report of the forth developing plan and intrudction of research, construction plans and financial support (budjet) for period of 2011-2014 A.C

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Global variation in diabetes diagnosis and prevalence based on fasting glucose and hemoglobin A1c

Fasting plasma glucose (FPG) and hemoglobin A1c (HbA1c) are both used to diagnose diabetes, but these measurements can identify different people as having diabetes. We used data from 117 population-based studies and quantified, in different world regions, the prevalence of diagnosed diabetes, and whether those who were previously undiagnosed and detected as having diabetes in survey screening, had elevated FPG, HbA1c or both. We developed prediction equations for estimating the probability that a person without previously diagnosed diabetes, and at a specific level of FPG, had elevated HbA1c, and vice versa. The age-standardized proportion of diabetes that was previously undiagnosed and detected in survey screening ranged from 30% in the high-income western region to 66% in south Asia. Among those with screen-detected diabetes with either test, the age-standardized proportion who had elevated levels of both FPG and HbA1c was 29-39% across regions; the remainder had discordant elevation of FPG or HbA1c. In most low- and middle-income regions, isolated elevated HbA1c was more common than isolated elevated FPG. In these regions, the use of FPG alone may delay diabetes diagnosis and underestimate diabetes prevalence. Our prediction equations help allocate finite resources for measuring HbA1c to reduce the global shortfall in diabetes diagnosis and surveillance

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency-Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research.Peer reviewe

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Extracorporeal Membrane Oxygenation for Severe Acute Respiratory Distress Syndrome associated with COVID-19: An Emulated Target Trial Analysis.

RATIONALE: Whether COVID patients may benefit from extracorporeal membrane oxygenation (ECMO) compared with conventional invasive mechanical ventilation (IMV) remains unknown. OBJECTIVES: To estimate the effect of ECMO on 90-Day mortality vs IMV only Methods: Among 4,244 critically ill adult patients with COVID-19 included in a multicenter cohort study, we emulated a target trial comparing the treatment strategies of initiating ECMO vs. no ECMO within 7 days of IMV in patients with severe acute respiratory distress syndrome (PaO2/FiO2 <80 or PaCO2 ≥60 mmHg). We controlled for confounding using a multivariable Cox model based on predefined variables. MAIN RESULTS: 1,235 patients met the full eligibility criteria for the emulated trial, among whom 164 patients initiated ECMO. The ECMO strategy had a higher survival probability at Day-7 from the onset of eligibility criteria (87% vs 83%, risk difference: 4%, 95% CI 0;9%) which decreased during follow-up (survival at Day-90: 63% vs 65%, risk difference: -2%, 95% CI -10;5%). However, ECMO was associated with higher survival when performed in high-volume ECMO centers or in regions where a specific ECMO network organization was set up to handle high demand, and when initiated within the first 4 days of MV and in profoundly hypoxemic patients. CONCLUSIONS: In an emulated trial based on a nationwide COVID-19 cohort, we found differential survival over time of an ECMO compared with a no-ECMO strategy. However, ECMO was consistently associated with better outcomes when performed in high-volume centers and in regions with ECMO capacities specifically organized to handle high demand. This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/)