The role of 99mTc-Ubiquicidin (UBI) and 99mTc-IgG scintigraphies in diagnosis of acute appendicitis: A preliminary result

Introduction: Appendicitis is one of the most common surgical emergencies. In spite of the relatively high rate of negative appendectomy, as a result of miss diagnosis, uncertainty of diagnosis still continues to challenge physicians. The objective of this prospective study was to investigate the role of 99mTc-Ubiquicidin (UBI) scintigraphy in the diagnosis of acute appendicitis and to compare 99mTc-UBI scintigraphy with 99mTc-IgG scintigraphy. Methods: Twelve patients with right lower quadrant pain and suspicious of acute appendicitis were referred to the nuclear medicine imaging center. Radionuclide imaging was performed with 99mTc-UBI in 8 and 99mTc-IgG in 4 patients. Ultrasonography, Alvarado scoring and histopathological examinations were also performed as additional diagnostic tests. Results: Reports from 99mTc-IgG and 99mTc-UBI scintigraphies of all patients were negative. Conclusion: This study may conclude that 99mTc-IgG scintigraphy and 99mTc-UBI scintigraphy in the detection of appendicitis do not have adequate efficacy. However, in order to better evaluate 99mTc-IgG and 99mTc-UBI scintigraphy, a comprehensive study on a large number of patients with clinical suspicious of acute appendicitis would be more helpful

Radiation exposure from diagnostic nuclear medicine examinations in golestan province

Introduction: The aim of present study was to estimate effective dose from most common procedures performed in nuclear medicine departments of Golestan province. Methods: Data of nuclear medicine procedures performed in 2 nuclear medicine departments in Golestan province were collected during 4 years. Effective dose, collective effective dose and effective dose per examination were calculated using standard dosimetry tables. Results: Based on the data of this study, results of 10437 nuclear medicine procedures performed during 4 years have lead to 3.97 mSv as average effective dose per examination and 10.37 human-Sv as mean collective effective dose. It was also revealed that Tc-99m was the main source of effective dose (98.3%), bone scan was the most common procedure (25.9%) and cardiac scan (MIBI-rest) has the highest collective effective dose (33.5%) during 4 years. Conclusion: Beside the cardiac scan which was the most common nuclear medicine procedure and the main contributor of effective dose in patients, due to geographical condition of the northeast of Iran, bone scan was the highest performed nuclear medicine examination in the Golestan province

Relation between clinical features and gastric emptying time in diabetic patients

BACKGROUND: Gastroparesis is characterized by delayed gastric emptying. This pathology is usually observed in patients with diabetes. One standard approach to quantitative assessment of gastric emptying is scintigraphic study. The aim of present study was to perform scintigraphic study of gastric emptying time in patient with diabetes and to find its correlation with patients' characteristics. MATERIALS AND METHODS: Gastric emptying was assessed in 19 patients with type 2 diabetes (mean age of 61.04 ± 6.09 years) and 6 healthy volunteers. Characteristics of the patients were sex, age, duration of diabetes, blood sugar and serum HbA1c level. RESULTS: Results of present study revealed that gastric emptying half time was significantly larger in patients with type 2 diabetes as compared with healthy volunteers (P-value < 0.05). While correlation of sex, age, duration of diabetes and blood sugar with gastric emptying time was not statistically significant, HbA1c level had significant effect on gastric emptying time. CONCLUSION: Results of this prospective study indicated that level of serum HbA1c is an effecting factor on gastric emptying time in patients with type 2 diabetes; however, these preliminary findings should be validated in larger and well-designed studies. Copyright © 2015 Via Medica

Size Control in the Nanoprecipitation Process of Stable Iodine (127I) Using Microchannel Reactor—Optimization by Artificial Neural Networks

In this study, nanosuspension of stable iodine (127I) was prepared by nanoprecipitation process in microfluidic devices. Then, size of particles was optimized using artificial neural networks (ANNs) modeling. The size of prepared particles was evaluated by dynamic light scattering. The response surfaces obtained from ANNs model illustrated the determining effect of input variables (solvent and antisolvent flow rate, surfactant concentration, and solvent temperature) on the output variable (nanoparticle size). Comparing the 3D graphs revealed that solvent and antisolvent flow rate had reverse relation with size of nanoparticles. Also, those graphs indicated that the solvent temperature at low values had an indirect relation with size of stable iodine (127I) nanoparticles, while at the high values, a direct relation was observed. In addition, it was found that the effect of surfactant concentration on particle size in the nanosuspension of stable iodine (127I) was depended on the solvent temperature. © 2015, American Association of Pharmaceutical Scientists

Tracking development assistance for health and for COVID-19 : a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990-2050

Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached$8. 8 trillion (95% uncertainty interval [UI] 8.7-8.8) or $1132 (1119-1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total,$40.4 billion (0.5%, 95% UI 0.5-0.5) was development assistance for health provided to low-income and middle-income countries, which made up 24.6% (UI 24.0-25.1) of total spending in low-income countries. We estimate that $54.8 billion in development assistance for health was disbursed in 2020. Of this,$13.7 billion was targeted toward the COVID-19 health response. $12.3 billion was newly committed and$1.4 billion was repurposed from existing health projects. $3.1 billion (22.4$2.4 billion (17.9%) was for supply chain and logistics. Only $714.4 million (7.7$1519 (1448-1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe

Correlation of 99mTc-DMSA scan with radiological and laboratory examinations in childhood acute pyelonephritis: A time-series study

Background: Urinary tract infections are one of the most common diseases in children. They may lead to hypertension and renal failure later in life. Renal scintigraphy with technetium-99m dimercaptosuccinic acid (99mTc-DMSA) is one method used to diagnose acute pyelonephritis (APN) and renal parenchymal scars. The aim of the present study was to determine the ideal time to perform a follow-up 99mTc-DMSA scan to detect renal scars and also to evaluate the factors predicting the development of permanent renal damage after APN. Methods: Sixty-four children with a first episode of APN underwent a 99mTc-DMSA scan. If there were abnormal findings on this scan, another scan was performed 6 and 12 months later. Results: The baseline 99mTc-DMSA scan showed cortical changes in 35 patients (54.7 %). One the 6- and 12-month follow-up scans, 25 patients (39.06 %) and 21 patients (32.8 %), respectively, had cortical lesions. In multiple logistic regressions with the final 99mTc-DMSA scan results as the dependent variable, only the age range of the patients (β = 1.062; 95 % CI 1.014-1.113; p = 0.01) showed an independent and significant association. Gender, therapeutic delay time, ultrasonography, and voiding cystourethrogram results, as well as laboratory test results including the erythrocyte sedimentation rate, C-reactive protein level, white blood cell counts, and type of bacteria in the urine, did not show such an association (p > 0.05). Conclusion: There is not a significant difference between the results of 6- and 12-month 99mTc-DMSA follow-up scans. A follow-up 99mTc-DMSA scan should be performed 12 months after the acute scan to yield a more accurate diagnosis of permanent renal damage. If present, long-term follow-up of patients is necessary. © 2013 Springer Science+Business Media Dordrecht

Tracking development assistance for health and for COVID-19: a review of development assistance, government, out-of-pocket, and other private spending on health for 204 countries and territories, 1990–2050

Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020. Methods We estimated domestic health spending and development assistance for health to generate total health-sector spending estimates for 204 countries and territories. We leveraged data from the WHO Global Health Expenditure Database to produce estimates of domestic health spending. To generate estimates for development assistance for health, we relied on project-level disbursement data from the major international development agencies' online databases and annual financial statements and reports for information on income sources. To adjust our estimates for 2020 to include disbursements related to COVID-19, we extracted project data on commitments and disbursements from a broader set of databases (because not all of the data sources used to estimate the historical series extend to 2020), including the UN Office of Humanitarian Assistance Financial Tracking Service and the International Aid Transparency Initiative. We reported all the historic and future spending estimates in inflation-adjusted 2020 US$, 2020 US$ per capita, purchasing-power parity-adjusted US$per capita, and as a proportion of gross domestic product. We used various models to generate future health spending to 2050. Findings In 2019, health spending globally reached$8·8 trillion (95% uncertainty interval [UI] 8·7–8·8) or $1132 (1119–1143) per person. Spending on health varied within and across income groups and geographical regions. Of this total,$40·4 billion (0·5%, 95% UI 0·5–0·5) was development assistance for health provided to low-income and middle-income countries, which made up 24·6% (UI 24·0–25·1) of total spending in low-income countries. We estimate that $54·8 billion in development assistance for health was disbursed in 2020. Of this,$13·7 billion was targeted toward the COVID-19 health response. $12·3 billion was newly committed and$1·4 billion was repurposed from existing health projects. $3·1 billion (22·4$2·4 billion (17·9%) was for supply chain and logistics. Only $714·4 million (7·7$1519 (1448–1591) per person in 2050, although spending across countries is expected to remain varied. Interpretation Global health spending is expected to continue to grow, but remain unequally distributed between countries. We estimate that development organisations substantially increased the amount of development assistance for health provided in 2020. Continued efforts are needed to raise sufficient resources to mitigate the pandemic for the most vulnerable, and to help curtail the pandemic for all

Cancer Incidence, Mortality, Years of Life Lost, Years Lived with Disability, and Disability-Adjusted Life Years for 29 Cancer Groups from 2010 to 2019: A Systematic Analysis for the Global Burden of Disease Study 2019

Importance: The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. Objective: To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. Evidence Review: The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95 uncertainty intervals (UIs). Findings: In 2019, there were an estimated 23.6 million (95 UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95 UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3 (95 UI, 20.3-32.3) increase in new cases, a 20.9 (95 UI, 14.2-27.6) increase in deaths, and a 16.0 (95 UI, 9.3-22.8) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4 (1.1-1.8) in the low SDI quintile to 5.7 (4.2-7.1) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. Conclusions and Relevance: The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world.. © 2021 American Medical Association. All rights reserved

Spatial, temporal, and demographic patterns in prevalence of smoking tobacco use and attributable disease burden in 204 countries and territories, 1990�2019: a systematic analysis from the Global Burden of Disease Study 2019

Background: Ending the global tobacco epidemic is a defining challenge in global health. Timely and comprehensive estimates of the prevalence of smoking tobacco use and attributable disease burden are needed to guide tobacco control efforts nationally and globally. Methods: We estimated the prevalence of smoking tobacco use and attributable disease burden for 204 countries and territories, by age and sex, from 1990 to 2019 as part of the Global Burden of Diseases, Injuries, and Risk Factors Study. We modelled multiple smoking-related indicators from 3625 nationally representative surveys. We completed systematic reviews and did Bayesian meta-regressions for 36 causally linked health outcomes to estimate non-linear dose-response risk curves for current and former smokers. We used a direct estimation approach to estimate attributable burden, providing more comprehensive estimates of the health effects of smoking than previously available. Findings: Globally in 2019, 1·14 billion (95 uncertainty interval 1·13�1·16) individuals were current smokers, who consumed 7·41 trillion (7·11�7·74) cigarette-equivalents of tobacco in 2019. Although prevalence of smoking had decreased significantly since 1990 among both males (27·5 26·5�28·5 reduction) and females (37·7% 35·4�39·9 reduction) aged 15 years and older, population growth has led to a significant increase in the total number of smokers from 0·99 billion (0·98�1·00) in 1990. Globally in 2019, smoking tobacco use accounted for 7·69 million (7·16�8·20) deaths and 200 million (185�214) disability-adjusted life-years, and was the leading risk factor for death among males (20·2% 19·3�21·1 of male deaths). 6·68 million 86·9% of 7·69 million deaths attributable to smoking tobacco use were among current smokers. Interpretation: In the absence of intervention, the annual toll of 7·69 million deaths and 200 million disability-adjusted life-years attributable to smoking will increase over the coming decades. Substantial progress in reducing the prevalence of smoking tobacco use has been observed in countries from all regions and at all stages of development, but a large implementation gap remains for tobacco control. Countries have a clear and urgent opportunity to pass strong, evidence-based policies to accelerate reductions in the prevalence of smoking and reap massive health benefits for their citizens. Funding: Bloomberg Philanthropies and the Bill & Melinda Gates Foundation. © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens