Automatic coronary artery calcium scoring on radiotherapy planning CT Scans of breast cancer patients: Reproducibility and association with traditional cardiovascular risk factors

Objectives Coronary artery calcium (CAC) is a strong and independent predictor of cardiovascular disease (CVD) risk. This study assesses reproducibility of automatic CAC scoring on radiotherapy planning computed tomography (CT) scans of breast cancer patients, and examines its association with traditional cardiovascular risk factors. Methods This study included 561 breast cancer patients undergoing radiotherapy between 2013 and 2015. CAC was automatically scored with an algorithm using supervised pattern recognition, expressed as Agatston scores and categorized into five categories (0, 1-10, 11-100, 101-400, >400). Reproducibility between automatic and manual expert scoring was assessed in 79 patients with automatically determined CAC above zero and 84 randomly selected patients without automatically determined CAC. Interscan reproducibility of automatic scoring was assessed in 294 patients having received two scans (82% on the same day). Association between CAC and CVD risk factors was assessed in 36 patients with CAC scores >100, 72 randomly selected patients with scores 1-100, and 72 randomly selected patients without CAC. Reliability was assessed with linearly weighted kappa and agreement with proportional agreement. Results 134 out of 561 (24%) patients had a CAC score above zero. Reliability of CVD risk categorization between automatic and manual scoring was 0.80 (95% Confidence Interval (CI): 0.74-0.87), and slightly higher for scans with breath-hold. Agreement was 0.79 (95% CI: 0.72-0.85). Interscan reliability was 0.61 (95% CI: 0.50-0.72) with an agreement of 0.84 (95% CI: 0.80-0.89). Ten out of 36 (27.8%) patients with CAC scores above 100 did not have other cardiovascular risk factors. Conclusions Automatic CAC scoring on radiotherapy planning CT scans is a reliable method to assess CVD risk based on Agatston scores. One in four breast cancer patients planned for radiotherapy have elevated CAC score. One in three patients with high CAC scores don't have other CVD risk factors and wouldn't have been identified as high risk

Elevated levels of numerous cytokines in drainage fluid after primary total hip arthroplasty

As cytokines are involved in wound healing and other inflammatory processes, it could be valuable to measure their levels at the operative site. This study was conducted to investigate whether different cytokines are measurable in drainage fluid and, when measurable, whether we can find a difference in cytokine levels between one and six hours postoperatively. Samples from the drainage system in 30 consecutive patients undergoing primary total hip replacement were collected at one and six hours after closure of the wound. Levels of several cytokines were measured in the drainage fluids. A significant elevation of almost all cytokines was observed between the sample after one hour and six hours postoperatively. We found a strong correlation between the different pro-inflammatory cytokines. The IL-6 to IL-10 ratio were also raised, showing a pro-inflammatory predominance. Levels were much higher than those previously shown in serum

1:1 and 2:1 Lithium Zincates with Intramolecular Coordination. Structures of Li(thf)Zn(C6H4CH2NMe2-2)3 and Li2Zn(C6H4CH2NMe2-2)4

Homoleptic lithium zincates with intramolecular Li-N coordination, i.e., Li(thf)nZn(C6H4CH2NMe2-2)3 (n = 0 (1); n = 1 (1(thf))) and Li2Zn(C6H4CH2NMe2-2)4 (2) have been prepared by reacting [Li(C6H4CH2NMe2-2)]4 with Zn(C6H4CH2NMe2-2)2. In the solid state 1(thf) is a monomer containing a distorted tetrahedral zinc atom. The zinc is surrounded by three monoanionic C6H4CH2NMe2-2 (dmba) ligands, which all show a different bonding mode: 1-C bonding to zinc and nitrogen coordination to lithium; 1,2-C bridge bonding to zinc and lithium with Li-N coordination; and C,N-chelate bonded to zinc. One thf coordinates to lithium. In the solid state, 2 is a monomeric dilithium tetraarylzincate complex containing a tetrahedral zinc atom. The four dmba ligands are all similarly 1,2-C bridge-bonded to zinc and lithium, and each lithium is four-coordinate by two additional Li-N bonds. The reaction of LiCH2SiMe3 and Zn(C6H4CH2NMe2-2)2 did not give a mixed zincate complex but the respective homoleptic zincate complexes instead. Both homoleptic and in situ prepared mixed zincate complexes react readily with 2-cyclohexen-1-one, but the product composition shows that the in situ prepared zincate disproportionates into the corresponding homoleptic zincates prior to reaction

Risk of death from cardiovascular disease following breast cancer: a systematic review

10.1007/s10549-017-4282-9Breast Cancer Research and Treatment1643537-555BCTR

A homologous series of homoleptic zinc bis(1,4-di-tert-butyl-1,4-diaza-1,3-butadiene) complexes: Kx[Zn(t-BuNCHCHN-t-Bu)2], Zn(t-BuNCHCHN-t-Bu)2, and [Zn(t-BuNCHCHN-t-Bu)2](OTf)x)(X=1,2)

A homologous series of mono- and dicationic, neutral, and mono- and dianionic zinc diazabutadiene complexes, Kx[Zn(t-BuNCHCHN-t-Bu)2], Zn(t-BuNCHCHN-t-Bu)2, and [Zn(t-BuNCHCHN-t-Bu)2](OTf)x (x = 1, 2), have been prepared and isolated in pure form. The crystal structures of the mono- and dicationic as well as of the monoanionic complexes are reported. In this series, the formal charge on the t-BuNCHCHN-t-Bu ligands ranges from -2 to +2, and the way in which the molecular geometry of the ligands varies with the charge is discussed. [Zn(t-BuNCHCHN-t-Bu)2](OTf)2 reacts with methanol to give 1,3-di-tert-butylimidazolium triflate. Crystal data: dicationic 2 ([Zn(t-BuNCHCHN-t-Bu)2](OTf)2, C22H40F6S2N4O6Zn), monoclinic, space group C2/c, with a = 18.015(6) Å, b = 9.257(6) Å, c = 20.012(5) Å, = 109.63(3), and Z = 4; monocationic 3·thf ([Zn(t-BuNCHCHN-t-Bu)2]OTf·thf, C25H48F3N4O3SZn), orthorhombic, space group P212121, with a = 10.3077(6) Å, b = 17.1974(6) Å, c = 17.8241(13) Å, and Z = 4; monoanionic 5·thf (K(thf)3[Zn(t-BuNCHCHN-t-Bu)2], C36H72KN4O3Zn), triclinic, space group P, with a = 10.8702(10) Å, b = 11.5175(9) Å, c = 18.2815(13) Å, = 73.795(6), = 74.227(6), = 75.736(7), and Z = 2; 7 (1,3-di-tert-butylimidazolium triflate, C12H21F3N2O3S), orthorhombic, space group Pbca, with a = 14.4086(8) Å, b = 12.0293(8) Å, c = 18.6985(12) Å, and Z = 8

Risk of death from cardiovascular disease following breast cancer in Southeast Asia: A prospective cohort study

10.1038/s41598-017-01540-7Scientific Reports71136

Risk of death from cardiovascular disease following breast cancer : a systematic review

Purpose: Breast cancer incidence and survival is high, which results in high prevalence of breast cancer survivors. The risk of (death from) cardiovascular disease (CVD) is higher in patients exposed to cardiotoxic treatments, in particular if they have pre-existing CVD risk factors. This study systematically summarized the risk of death from CVD following breast cancer. Methods: Databases of Medline, Embase, and the Cochrane Library were systematically searched using the following terms and synonyms: breast cancer, cardiovascular disease, and cause of death. Articles reporting on both risk and risk factors of CVD mortality following breast cancer were eligible for inclusion. The methodological quality of each article was assessed using the Newcastle Ottawa quality assessment scale for cohort studies. Results: Fourteen articles were included assessing the risk of CVD mortality among 1,217,910 women with breast cancer. The methodological quality was high for the majority of the studies. Studies were heterogeneous in design, study population, length of follow-up, CVD outcomes, and risk factors. 1.6–10.4% of all women with breast cancer died of CVD. Women with breast cancer had a higher risk of CVD mortality than women from the general population. The risk of CVD mortality was higher among women with breast cancer with older age at diagnosis, left-sided tumor, diagnosis in an earlier calendar period, and black ethnic origin. Conclusions: CVD is an important cause of death following breast cancer. Identification of patients at high risk of CVD is important to optimize CVD prevention and tailor breast cancer treatment

Risk of death from cardiovascular disease following breast cancer : a systematic review

Purpose: Breast cancer incidence and survival is high, which results in high prevalence of breast cancer survivors. The risk of (death from) cardiovascular disease (CVD) is higher in patients exposed to cardiotoxic treatments, in particular if they have pre-existing CVD risk factors. This study systematically summarized the risk of death from CVD following breast cancer. Methods: Databases of Medline, Embase, and the Cochrane Library were systematically searched using the following terms and synonyms: breast cancer, cardiovascular disease, and cause of death. Articles reporting on both risk and risk factors of CVD mortality following breast cancer were eligible for inclusion. The methodological quality of each article was assessed using the Newcastle Ottawa quality assessment scale for cohort studies. Results: Fourteen articles were included assessing the risk of CVD mortality among 1,217,910 women with breast cancer. The methodological quality was high for the majority of the studies. Studies were heterogeneous in design, study population, length of follow-up, CVD outcomes, and risk factors. 1.6–10.4% of all women with breast cancer died of CVD. Women with breast cancer had a higher risk of CVD mortality than women from the general population. The risk of CVD mortality was higher among women with breast cancer with older age at diagnosis, left-sided tumor, diagnosis in an earlier calendar period, and black ethnic origin. Conclusions: CVD is an important cause of death following breast cancer. Identification of patients at high risk of CVD is important to optimize CVD prevention and tailor breast cancer treatment

Risk of death from cardiovascular disease following breast cancer in Southeast Asia : a prospective cohort study

Breast cancer incidence and survival is high in Southeast Asia. As such, many women diagnosed with breast cancer are at risk of dying of other causes. Given the increased risk of cardiotoxicity induced by breast cancer treatments, it is important to identify patients at high risk of cardiovascular disease (CVD) mortality. The aim of this study was to investigate if this risk varies by age and ethnicity. Patient details were obtained from 5,868 Chinese, Malay, and Indian women diagnosed with in situ or non-metastasized invasive breast cancer at the National University Hospital of Singapore and KK Women's and Children's Hospital in Singapore. Death causes were obtained from the National Registry of Births and Deaths. Flexible parametric survival models estimated CVD mortality rates and hazard ratios. During a median follow-up of six years, 1,010 deaths occurred of which 6.8% were due to CVD. CVD mortality rates of older women peaked within the first year following diagnosis and increased over time since diagnosis. Indian had more than double the risk of CVD mortality than Chinese, independent of age at diagnosis and stage. Taking ethnicity and age into account may promote CVD risk stratification and management in (Southeast Asian) women with breast cancer