19 research outputs found
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Amniotic fluid volume: Rapid MR-based assessment at 28-32Â weeks gestation.
OBJECTIVES: This work evaluates rapid magnetic resonance projection hydrography (PH) based amniotic fluid volume (AFV) estimates against established routine ultrasound single deepest vertical pocket (SDVP) and amniotic fluid index (AFI) measurements, in utero at 28-32Â weeks gestation. Manual multi-section planimetry (MSP) based measurement of AFV is used as a proxy reference standard. METHODS: Thirty-five women with a healthy singleton pregnancy (20-41Â years) attending routine antenatal ultrasound were recruited. SDVP and AFI were measured using ultrasound, with same day MRI assessing AFV with PH and MSP. The relationships between the respective techniques were assessed using linear regression analysis and Bland-Altman method comparison statistics. RESULTS: When comparing estimated AFV, a highly significant relationship was observed between PH and the reference standard MSP (R(2)â=â0.802, pâ<â0.001). For the US measurements, SDVP measurement related most closely to amniotic fluid volume, (R(2)â=â0.470, pâ<â0.001), with AFI demonstrating a weaker relationship (R(2)â=â0.208, pâ=â0.007). CONCLUSION: This study shows that rapid MRI based PH measurement is a better predictor of AFV, relating more closely to our proxy standard than established US techniques. Although larger validation studies across a range of gestational ages are required this approach could form part of MR fetal assessment, particularly where poly- or oligohydramnios is suspected. KEY POINTS: âą MR projection hydrography can be used to estimate amniotic fluid volume. âą MR projection hydrography relies on the T2w signal from amniotic fluid. âą Amniotic fluid volume (AFV) is more accurately assessed than with ultrasound.This study was supported by the National Institute of Health Research, Cambridge Biomedical Research Centre. The authors also acknowledge the support of Addenbrookeâs Charitable Trust and thank the participants for their contribution to the study.This is the author accepted manuscript. The final version is available from Springer via http://dx.doi.org/10.1007/s00330-015-4179-
Feasibility and results of a randomised pilot-study of pre-discharge occupational therapy home visits
BACKGROUND: Pre-discharge home visits aim to maximise independence in the community. These visits involve assessment of a person in their own home prior to discharge from hospital, typically by an occupational therapist. The therapist may provide equipment, adapt the home environment and/or provide education. The aims of this study were to investigate the feasibility of a randomised controlled trial in a clinical setting and the effect of pre-discharge home visits on functional performance in older people undergoing rehabilitation. METHODS: Ten patients participating in an inpatient rehabilitation program were randomly assigned to receive either a pre-discharge home visit (intervention), or standard practice in-hospital assessment and education (control), both conducted by an occupational therapist. The pre-discharge home visit involved assessment of the older person's function and environment, and education, and took an average of 1.5 hours. The hospital-based interview took an average of 40 minutes. Outcome data were collected by a blinded assessor at 0, 2, 4, 8 and 12 weeks. Outcomes included performance of activities of daily living, reintegration to community living, quality of life, readmission and fall rates. RESULTS: Recruitment of 10 participants was slow and took three months. Observed performance of functional abilities did not differ between groups due to the small sample size. Difference in activities of daily living participation, as recorded by the Nottingham Extended Activities of Daily Living scale, was statistically significant but wide confidence intervals and low statistical power limit interpretation of results. CONCLUSION: Evaluation of pre-discharge home visits by occupational therapists in a rehabilitation setting is feasible, but a more effective recruitment strategy for a main study is favored by application of a multi-centre setting
Unifying activity, structure, and spectroscopy of [NiFe] hydrogenases: Combining techniques to clarify mechanistic understanding
Achieving a unified understanding of the mechanism of a multicenter redox enzyme such as [NiFe] hydrogenase is complicated by difficulties in reconciling information obtained by using different techniques and on samples in different physical forms. Measurements of the activity of the enzyme, and of factors which perturb activity, are generally carried out using biochemical assays in solution or with electrode-immobilized enzymes using protein film electrochemistry (PFE). Conversely, spectroscopy aimed at reporting on features of the metalloclusters in the enzyme, such as electron paramagnetic resonance (EPR) or X-ray absorption spectroscopy (XAS), is often conducted on frozen samples and is thus difficult to relate to catalytically relevant states as information about turnover and activity has been lost. To complicate matters further, most of our knowledge of the atomic-level structure of metalloenzymes comes from X-ray diffraction studies in the solid, crystalline state, which are again difficult to link to turnover conditions. Taking [NiFe] hydrogenases as our case study, we show here how it is possible to apply infrared (IR) spectroscopic sampling approaches to unite direct spectroscopic study with catalytic turnover. Using a method we have named protein film IR electrochemistry (PFIRE), we reveal the steady-state distribution of intermediates during catalysis and identify catalytic âbottlenecksâ introduced by site-directed mutagenesis. We also show that it is possible to study dynamic transitions between active site states of enzymes in single crystals, uniting solid state and solution spectroscopic information. In all of these cases, the spectroscopic data complement and enhance interpretation of purely activity-based measurements by providing direct chemical insight that is otherwise hidden. The [NiFe] hydrogenases possess a bimetallic [NiFe] active site, coordinated by CO and CNâ ligands, linked to the protein via bridging and terminal cysteine sulfur ligands, as well as an electron relay chain of iron sulfur clusters. Infrared spectroscopy is ideal for probing hydrogenases because the CO and CNâ ligands are strong IR absorbers, but the suite of IR-based approaches we describe here will be equally valuable in studying substrate- or intermediate-bound states of other metalloenzymes where key mechanistic questions remain open, such as nitrogenase, formate dehydrogenase, or carbon monoxide dehydrogenase. We therefore hope that this Account will encourage future studies which unify information from different techniques across bioinorganic chemistry
Detection of candidate biomarkers of prostate cancer progression in serum: a depletion-free 3D LC/MS quantitative proteomics pilot study
Background: Prostate cancer (PCa) is the most common male cancer in the United Kingdom and we aimed to identify clinically relevant biomarkers corresponding to stage progression of the disease. Methods: We used enhanced proteomic profiling of PCa progression using iTRAQ 3D LC mass spectrometry on high-quality serum samples to identify biomarkers of PCa. Results: We identified >1000 proteins. Following specific inclusion/exclusion criteria we targeted seven proteins of which two were validated by ELISA and six potentially interacted forming an âinteractomeâ with only a single protein linking each marker. This network also includes accepted cancer markers, such as TNF, STAT3, NF-ÎșB and IL6. Conclusions: Our linked and interrelated biomarker network highlights the potential utility of six of our seven markers as a panel for diagnosing PCa and, critically, in determining the stage of the disease. Our validation analysis of the MS-identified proteins found that SAA alongside KLK3 may improve categorisation of PCa than by KLK3 alone, and that TSR1, although not significant in this model, might also be a clinically relevant biomarker
Ketorolac tromethamine associated with diffuse pulmonary haemorrhage: high-resolution CT findings
Intramuscular leukemic relapse: clinical signs and imaging findings. A multicentric analysis
ImportĂąncia da ecogenicidade da tireĂłide no diagnĂłstico da tireoidite crĂŽnica auto-imune Value of thyroid echogenicity in the diagnosis of chronic autoimmune thyroiditis
A tireoidite crĂŽnica auto-imune Ă©, atualmente, a principal causa de hipotireoidismo e seu diagnĂłstico baseia-se nas manifestaçÔes clĂnico-laboratoriais. O marcador laboratorial mais importante Ă© a presença de anticorpos antitireoglobulina e antiperoxidase, sendo este Ășltimo o teste mais sensĂvel. A biĂłpsia aspirativa apresenta alta sensibilidade e especificidade, porĂ©m, Ă© um mĂ©todo invasivo e, por isso, reservado para quando hĂĄ presença de nĂłdulo ou bĂłcio de crescimento rĂĄpido. A cintilografia Ă© desnecessĂĄria para o diagnĂłstico, jĂĄ que apresenta baixa sensibilidade e especificidade. A ultra-sonografia, tanto ao modo B como ao dĂșplex-Doppler colorido, evoluiu de forma muito rĂĄpida e tornou-se um mĂ©todo simples, nĂŁo-invasivo, reprodutĂvel e com alta sensibilidade para o diagnĂłstico da tireoidite crĂŽnica auto-imune. Ao modo B, a ecogenicidade Ă© um parĂąmetro de extrema importĂąncia, jĂĄ que, alĂ©m de apresentar alta correlação com o quadro citopatolĂłgico, tambĂ©m apresenta alta sensibilidade para o diagnĂłstico da tireoidite crĂŽnica auto-imune. Embora este parĂąmetro nĂŁo seja especĂfico da tireoidite crĂŽnica auto-imune, pois tambĂ©m pode estar presente na doença de Graves, na tireoidite pĂłs-parto e na tireoidite subaguda, tais desordens podem ser facilmente diferenciadas tanto pelo quadro clĂnico-laboratorial quanto pelo dĂșplex-Doppler colorido. Assim, este artigo tem o objetivo de revisar a importĂąncia do estudo da ecogenicidade no diagnĂłstico da tireoidite crĂŽnica auto-imune.<br>Chronic autoimmune thyroiditis is currently considered as the main cause for hypothyroidism and its diagnosis is based on clinical manifestations and laboratory tests results. The most significant laboratory marker for this disease is the presence of anti-thyroperoxidase and anti-thyroglobulin antibodies, the latter being the most sensitive one. Aspiration biopsy shows high sensitivity and specificity but, considering the invasiveness of this method it is reserved for cases of suspected nodules or fast growing goiter. Scintigraphy is unnecessary for the diagnosis, considering its low specificity and sensitivity. Both B-mode and duplex color Doppler ultrasonography have rapidly evolved, becoming a simple, noninvasive and reproducible method with high sensitivity for the diagnosis of chronic autoimmune thyroiditis. Echogenicity is a relevant parameter at B-mode ultrasonography because of the close correlation with cytopathological findings besides the high sensitivity in the diagnosis of the disease. Although this is not a specific parameter for chronic autoimmune thyroiditis, considering that it may also be found in Graves' disease, postpartum thyroiditis and subacute thyroiditis, such disorders can be easily differentiated both by clinical-laboratory and duplex color Doppler findings. Thus, the present study is aimed at evaluating the significance of thyroid echogenicity in the diagnosis of chronic autoimmune thyroiditis