Comparison of Tmax values between full- and half-dose gadolinium perfusion studies.
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ABSTRACT:
SUBMITTER: Christensen S
PROVIDER: S-EPMC8370009 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:OBJECTIVES:Recent evidence suggests that half-dose thrombolysis for pulmonary embolism may provide similar efficacy with reduced bleeding risk compared with full-dose therapy, but comparative studies are lacking. We aimed to evaluate the effectiveness and safety of half-dose versus full-dose alteplase for treatment of pulmonary embolism. DESIGN:A retrospective cohort study comparing outcomes in patients receiving half-dose (50?mg) versus full-dose (100?mg) alteplase for pulmonary embolism. We used propensity score matching and sensitivity analyses to address confounding and hospital-level clustering. SETTING:Data from 420 hospitals obtained from the Premier Healthcare Database between January 2010 and December 2014. SUBJECTS:Adult critically ill patients with acute pulmonary embolism treated with IV alteplase therapy. INTERVENTIONS:None. MEASUREMENTS AND MAIN RESULTS:This study included 3,768 patients: 699 (18.6%) in the half-dose and 3,069 (81.4%) in the full-dose group. At baseline, patients receiving half-dose alteplase required vasopressor therapy (23.3% vs 39.4%; p < 0.01) and invasive ventilation (14.3% vs 28.5%; p < 0.01) less often, compared with full dose. After propensity matching (n = 548 per group), half-dose alteplase was associated with increased treatment escalation (53.8% vs 41.4%; p < 0.01), driven mostly by secondary thrombolysis (25.9% vs 7.3%; p < 0.01) and catheter thrombus fragmentation (14.2% vs 3.8%; p < 0.01). Hospital mortality was similar (13% vs 15%; p = 0.3). There was no difference in cerebral hemorrhage (0.5% vs 0.4%; p = 0.67), gastrointestinal bleeding (1.6% vs 1.6%; p = 0.99), acute blood loss anemia (6.9% vs 4.6%; p = 0.11), use of blood products (p > 0.05 for all), or documented fibrinolytic adverse events (2.6% vs 2.8%; p = 0.82). CONCLUSIONS:Compared with full-dose alteplase, half-dose was associated with similar mortality and rates of major bleeding. Treatment escalation occurred more often in half-dose-treated patients. These results question whether half-dose alteplase provides similar efficacy with improved safety, and highlights the need for further study before use of half-dose alteplase therapy can be routinely recommended in patients with pulmonary embolism.
| S-EPMC6375681 | biostudies-literature
Project description:PurposeTo evaluate the reproducibility and predicted clinical outcomes of CT-based quantitative lung density measurements using standard fixed-dose (FD) and reduced-dose (RD) scans.Materials and methodsIn this retrospective analysis of prospectively acquired data, 1205 participants (mean age, 65 years ± 9 [standard deviation]; 618 men) enrolled in the COPDGene study who underwent FD and RD CT image acquisition protocols between November 2014 and July 2017 were included. Of these, the RD scans of 640 participants were also reconstructed using iterative reconstruction (IR). Median filtering was applied to the RD scans (RD-MF) to investigate an alternative noise reduction strategy. CT attenuation at the 15th percentile of the lung CT histogram (Perc15) was computed for all image types (FD, RD, RD-MF, and RD-IR). Reproducibility coefficients were calculated to quantify the measurement differences between FD and RD scans. The ability of Perc15 to predict chronic obstructive pulmonary disease (COPD) diagnosis and exacerbation frequency was investigated using receiver operating characteristic analysis.ResultsThe Perc15 reproducibility coefficients with and without volume adjustment were as follows: RD, 29.43 HU ± 0.62 versus 32.81 HU ± 1.70; RD-MF, 7.42 HU ± 0.42 versus 19.40 HU ± 2.65; and RD-IR, 7.10 HU ± 0.52 versus 22.46 HU ± 3.91. Receiver operating characteristic curve analysis indicated that Perc15 on volume-adjusted FD and RD scans were both predictive for COPD diagnosis (area under the receiver operating characteristic curve [AUC]: FD, 0.724 ± 0.045; RD, 0.739 ± 0.045) and for having one or more exacerbation per year (AUCs: FD, 0.593 ± 0.068; RD, 0.589 ± 0.066). Similar trends were observed when volume adjustment was not applied.ConclusionA combination of volume adjustment and noise reduction filtering improved the reproducibility of lung density measurements computed using serial FD and RD CT scans.Supplemental material is available for this article.© RSNA, 2021.
| S-EPMC8098098 | biostudies-literature
Project description:This data was utilized to assess the utility of perfusion culture in cultivating spheroids of sarcoma cells. The differences between spheroids cultured with perfusion and without perfusion were analyzed through mass spectrometry. The spheroids were fabricated from NCC-UPS4-C1 cell line derived from a patient with undifferentiated pleomorphic sarcoma.
2024-02-02 | PXD049106 | JPOST Repository
Project description:Moyamoya disease (MMD) is a chronic, steno-occlusive cerebrovascular disorder of unknown etiology. Surgical treatment is the only known effective method to restore blood flow to affected areas of the brain. However, there are lack of generally accepted noninvasive tools for therapeutic outcome monitoring. As dynamic susceptibility contrast (DSC) magnetic resonance imaging (MRI) is the standard MR perfusion imaging technique in the clinical setting, we investigated a dataset of nineteen pediatric MMD patients with one preoperational and multiple periodic DSC MRI examinations for four to thirty-eight months after indirect revascularization. A rigid gamma variate model was used to derive two nondeconvolution-based perfusion parameters: time to peak (TTP) and full width at half maximum (FWHM) for monitoring transitional bolus delay and dispersion changes respectively. TTP and FWHM values were normalized to the cerebellum. Here, we report that 74% (14/19) of patients improve in both TTP and FWHM measurements, and whereof 57% (8/14) improve more noticeably on FWHM. TTP is in good agreement with Tmax in estimating bolus delay. Our study data also suggest bolus dispersion estimated by FWHM is an additional, informative indicator in pediatric MMD monitoring.
| S-EPMC7804964 | biostudies-literature
Project description:In this report we directly compare the in vivo and in vitro MRI properties of gadolinium-dendrimer conjugates of derivatized acyclic diethylenetriamine-N,N',N',N'',N''-pentaacetic acid (1B4M-DTPA) and macrocyclic 1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetic acid (C-DOTA). The metal-ligand chelates were pre-formed in alcohol prior to conjugation to the generation 4 PAMAM dendrimer (G4D), and the dendrimer-based agents were purified by Sephadex(R) G-25 column. The analysis and SE-HPLC data indicated chelate to dendrimer ratios of 30:1 and 28:1, respectively. Molar relaxivity measured at pH 7.4, 22 degrees C, and 3T are comparable (29.5 vs 26.9 mM(-1)s(-1)), and both conjugates are equally viable as MRI contrast agents based on the images obtained. The macrocyclic agent however exhibits a faster rate of clearance in vivo (t(1/2)=16 vs 29 min). Our conclusion is that the macrocyclic-based agent is the more suitable agent for in vivo use for these reasons combined with kinetic inertness associated with the Gd(III) DOTA complex stability properties.
| S-EPMC2918719 | biostudies-literature
Project description:PurposeCurrently, several active clinical trials of functional lung avoidance radiation therapy using different imaging modalities for ventilation or perfusion are underway. Patients with lung cancer often show ventilation-perfusion mismatch, whereas the significance of dose-function metric remains unclear. The aim of the present study was to compare dose-ventilation metrics with dose-perfusion metrics for radiation therapy plan evaluation.Methods and materialsPretreatment 4-dimensional computed tomography and 99mTc-macroaggregated albumin single-photon emission computed tomography perfusion images of 60 patients with lung cancer treated with radiation therapy were analyzed. Ventilation images were created using the deformable image registration of 4-dimensional computed tomography image sets and image analysis for regional volume changes as a surrogate for ventilation. Ventilation and perfusion images were converted into percentile distribution images. Analyses included Pearson's correlation coefficient and comparison of agreements between the following dose-ventilation and dose-perfusion metrics: functional mean lung dose and functional percent lung function receiving 5, 10, 20, 30, and 40 Gy (fV5, fV10, fV20, fV30, and fV40, respectively).ResultsOverall, the dose-ventilation metrics were greater than the dose-perfusion metrics (ie, fV20, 26.3% ± 9.9% vs 23.9% ± 9.8%). Correlations between the dose-ventilation and dose-perfusion metrics were strong (range, r = 0.94-0.97), whereas the agreements widely varied among patients, with differences as large as 6.6 Gy for functional mean lung dose and 11.1% for fV20. Paired t test indicated that the dose-ventilation and dose-perfusion metrics were significantly different.ConclusionsStrong correlations were present between the dose-ventilation and dose-perfusion metrics. However, the agreement between the dose-ventilation and dose-perfusion metrics widely varied among patients, suggesting that ventilation-based radiation therapy plan evaluation may not be comparable to that based on perfusion. Future studies should elucidate the correlation of dose-function metrics with clinical pulmonary toxicity metrics.
| S-EPMC7280081 | biostudies-literature
Project description:ObjectivesPreviously, we presented the effectiveness of ChAdOx1 nCoV-19 half-dose (HD) immunization for preventing new COVID-19 cases. Here, we evaluated the administration of an HD of ChAdOx1 nCoV-19 in the primary immunization protocol (up to two doses) in reducing moderate and severe cases, hospitalizations, and deaths when compared to the administration of full doses (FD) after a long-term follow-up.MethodsWe evaluated data from 29,469 participants between January 2021 and November 2022 who received an HD or FD vaccine and crossed this information with their medical records to identify those who developed moderate or severe cases. All participants were classified into four groups according to their immunization status and followed 500 days after the last vaccine administration.ResultsThe propensity-score matching analysis indicates that the administration of the two HDs of ChAdOx1 nCoV-19 was equivalent to the use of two FDs to reduce moderate and severe COVID-19 cases. The relative risk of being infected and developing moderate or severe conditions after the administration of at least one HD or FD was similar 150 or 500 days after the administration of the immunizers.ConclusionAdministering two HDs can be used safely as a cost-effective alternative to the primary immunization protocol.
| S-EPMC10637913 | biostudies-literature
Project description:During cancer progression genomes undergo point mutations as well as larger segmental changes. The latter include, among others, segmental deletions duplications, translocations and inversions.The result is a highly complex, patient-specific cancer karyotype. Using high-throughput technologies of deep sequencing and microarrays it is possible to interrogate a cancer genome and produce chromosomal copy number profiles and a list of breakpoints ("jumps") relative to the normal genome. This information is very detailed but local, and does not give the overall picture of the cancer genome. One of the basic challenges in cancer genome research is to use such information to infer the cancer karyotype. We present here an algorithmic approach, based on graph theory and integer linear programming, that receives segmental copy number and breakpoint data as input and produces a cancer karyotype that is most concordant with them. We used simulations to evaluate the utility of our approach, and applied it to real data.By using a simulation model, we were able to estimate the correctness and robustness of the algorithm in a spectrum of scenarios. Under our base scenario, designed according to observations in real data, the algorithm correctly inferred 69% of the karyotypes. However, when using less stringent correctness metrics that account for incomplete and noisy data, 87% of the reconstructed karyotypes were correct. Furthermore, in scenarios where the data were very clean and complete, accuracy rose to 90%-100%. Some examples of analysis of real data, and the reconstructed karyotypes suggested by our algorithm, are also presented.While reconstruction of complete, perfect karyotype based on short read data is very hard, a large fraction of the reconstruction will still be correct and can provide useful information.
| S-EPMC5688766 | biostudies-literature
Project description:BackgroundChildren 6 through 35 months of age are recommended to receive half the dose of influenza vaccine compared with older children and adults.MethodsThis was a 6-site, randomized 2:1, double-blind study comparing full-dose (0.5 mL) trivalent inactivated influenza vaccine (TIV) with half-dose (0.25 mL) TIV in children 6 through 35 months of age. Children previously immunized with influenza vaccine (primed cohort) received 1 dose, and those with no previous influenza immunizations (naive cohort) received 2 doses of TIV. Local and systemic adverse events were recorded. Sera were collected before immunization and 1 month after last dose of TIV. Hemagglutination inhibition antibody testing was performed.ResultsOf the 243 subjects enrolled (32 primed, 211 naive), data for 232 were available for complete analysis. No significant differences in local or systemic reactions were observed. Few significant differences in immunogenicity to the 3 vaccine antigens were noted. The immune response to H1N1 was significantly higher in the full-dose group among primed subjects. In the naive cohort, the geometric mean titer for all 3 antigens after 2 doses of TIV were significantly higher in the 12 through 35 months compared with the 6 through 11 months age group.ConclusionsOur study confirms the safety of full-dose TIV given to children 6 through 35 months of age. An increase in antibody responses after full- versus half-dose TIV was not observed, except for H1N1 in the primed group. Larger studies are needed to clarify the potential for improved immunogenicity with higher vaccine doses. Recommending the same dose could simplify the production, storage, and administration of influenza vaccines.
| S-EPMC4554205 | biostudies-literature
Project description:There are concerns about the risk of injuries caused by marathons in China. Since male and female runners have different injury risks, gender differences in running shoe functionality should be further complemented. A supervised questionnaire survey of 626 marathon runners was collected. The questionnaire was categorized into four sections: (1) participant profile, (2) importance of shoe properties, (3) functional evaluation of shoe properties and (4) importance ranking of shoe properties. The Mann-Whitney U test, Fisher's exact test of cross tabulation and Chi-square test, and two-way ANOVA were used to analyze the results of this survey. The significance level was set at P < 0.05. The full marathon participants were older than the half marathon participants. There was no gender difference in the importance of shoe features to elite runners. In addition, women are more concerned about upper elasticity and have higher requirements for running shoes than men. Women were more focused on injury prevention, while men were more focused on running performance. Heel cushioning was identified by all participants as the most important running shoe feature. There were no gender differences between elite players' demand for running shoes, but significant gender differences were found between genders at other running levels.
| S-EPMC10415251 | biostudies-literature